Provider Demographics
NPI:1356478952
Name:CONNORS HEALTHCARE FOR WOMEN PA
Entity Type:Organization
Organization Name:CONNORS HEALTHCARE FOR WOMEN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:K
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-531-1516
Mailing Address - Street 1:1181HUTTO ROAD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118
Mailing Address - Country:US
Mailing Address - Phone:803-531-1516
Mailing Address - Fax:803-531-1523
Practice Address - Street 1:1181HUTTO ROAD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118
Practice Address - Country:US
Practice Address - Phone:803-531-1516
Practice Address - Fax:803-531-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8227Medicare PIN