Individual
MR. ROBERT LEE RIDGEWAY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2022 CARDINAL CIR, ANDERSON, SC 29621-1504
(864) 224-7577
(864) 225-5165
Mailing address
2022 CARDINAL CIR, ANDERSON, SC 29621-1504
(864) 224-7577
(864) 225-5165
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2119
SC
363A00000X
Physician Assistant
2119
SC
363AS0400X
Surgical Physician Assistant
2119
SC
Other
Enumeration date
07/02/2014
Last updated
12/12/2023
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