Provider Demographics
NPI:1164682373
Name:FRU, KARENNE NSTANG (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:KARENNE
Middle Name:NSTANG
Last Name:FRU
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:KARENNE
Other - Middle Name:NSTANG
Other - Last Name:FRU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2324 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4716
Mailing Address - Country:US
Mailing Address - Phone:803-726-3600
Mailing Address - Fax:803-929-0504
Practice Address - Street 1:2324 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4716
Practice Address - Country:US
Practice Address - Phone:803-726-3600
Practice Address - Fax:803-929-0504
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201302150207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology