Individual
SUSAN CAUDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2750 LAUREL ST STE 305, COLUMBIA, SC 29204-2025
(803) 254-5140
(803) 779-1279
Mailing address
PO BOX 935722, ATLANTA, GA 31193-5722
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 335
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3047PA
—
SC
Enumeration date
07/10/2014
Last updated
08/25/2021
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