Basic Information
| Provider Information | |||||||||
| NPI: | 1174817167 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RIDLEY | ||||||||
| FirstName: | CELIA | ||||||||
| MiddleName: | JANETTE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 890 W FARIS RD | ||||||||
| Address2: | MMOB SUITE 470 | ||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296054253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644557887 | ||||||||
| FaxNumber: | 8644556875 | ||||||||
| Practice Location | |||||||||
| Address1: | 890 W FARIS RD | ||||||||
| Address2: | MMOB SUITE 470 | ||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296054253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644557887 | ||||||||
| FaxNumber: | 8644556875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2011 | ||||||||
| LastUpdateDate: | 06/07/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | LL33550 | SC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.