Individual
RICHARD KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 MAIN STREET, SUMMERVILLE, SC 29483-6627
(843) 876-2121
Mailing address
PO BOX 602108, CHARLOTTE, NC 28260-2108
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
85279
SC
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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