Individual
DR. STACY RENEE CAUDILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9298 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9125
(843) 572-8277
Mailing address
9298 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9125
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL29043
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290438
—
SC
Enumeration date
11/07/2006
Last updated
05/20/2009
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