Organization
RIBAUT MEDICAL PARTNERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL CLARK TRASK MD (OWNER)
(843) 524-2001
Entity
Organization
Contact information
Practice address
1094 RIBAUT RD, BEAUFORT, SC 29902-5437
(843) 524-2001
Mailing address
PO BOX 2329, BEAUFORT, SC 29901-2329
(843) 524-2001
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD22623
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11363059
CAQH
—
01
—
22623
MEDICAL LICENSE
SC
05
—
266232
—
SC
Enumeration date
09/13/2017
Last updated
03/07/2023
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