Provider Demographics
NPI:1609996180
Name:FRUH, JEAN M (EDD, AT,C,)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:M
Last Name:FRUH
Suffix:
Gender:F
Credentials:EDD, AT,C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 KINGSTON CV
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-4936
Mailing Address - Country:US
Mailing Address - Phone:843-341-9439
Mailing Address - Fax:
Practice Address - Street 1:9 KINGSTON CV
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4936
Practice Address - Country:US
Practice Address - Phone:843-341-9439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC833174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist