Provider Demographics
NPI:1558655613
Name:DUNCAN, SUSAN GANANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:GANANN
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 MELTON CT
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-7188
Mailing Address - Country:US
Mailing Address - Phone:843-572-1676
Mailing Address - Fax:843-572-1676
Practice Address - Street 1:7250 RIVERS AVE
Practice Address - Street 2:TARGET 1829
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4625
Practice Address - Country:US
Practice Address - Phone:843-572-8918
Practice Address - Fax:843-572-8918
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10792183500000X
MSE-08214183500000X
LA16648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist