Individual
KIMBERLY LYNN BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
133 N HOWARD AVE, LANDRUM, SC 29356-1507
(864) 560-9507
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13414
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134143
—
SC
01
—
5471026
AETNA
SC
01
—
58918
MEDCOST
SC
05
—
890577I
—
NC
Enumeration date
01/31/2006
Last updated
12/02/2020
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