Individual
KATRINA FULLER QUICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
139 LILA DOYLE DR, SENECA, SC 29672-9495
(864) 482-3483
(864) 482-3497
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82630
SC
207Q00000X
Family Medicine Physician
MD60842142
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
826306
—
SD
Enumeration date
06/17/2015
Last updated
06/23/2021
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