Individual
JEFFERY M REUBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 OKATIE CTR BLVD STE 205, OKATIE, SC 29909-7511
(843) 379-7746
(843) 522-1275
Mailing address
PO BOX 670, PORT ROYAL, SC 29935-0670
(843) 379-7746
(843) 522-1275
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21737
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T59460
—
SC
Enumeration date
11/08/2006
Last updated
08/30/2023
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