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Individual

LAWRENCE EDWIN RUDISILL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1011 FRONTAGE RD, GREENVILLE, SC 29615-4240
(864) 242-4263
(864) 242-2250
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617

Taxonomy

Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
10481
SC
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
10481
SC
2086S0105X
Surgery of the Hand (Surgery) Physician
MD61280339
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104817
SC
Enumeration date
05/10/2006
Last updated
03/24/2022
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