Individual
RONNIE ALAN BROCKWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 STORK WAY, SENECA, SC 29678-1039
(864) 882-1311
(864) 882-1350
Mailing address
215 STORK WAY, SENECA, SC 29678-1039
(864) 882-1311
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
10721
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA7956
—
SC
Enumeration date
10/04/2005
Last updated
05/08/2008
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