Provider Demographics
NPI:1629416219
Name:REPPERT, PATRICK RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:RAY
Last Name:REPPERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:325 FOLLY RD
Practice Address - Street 2:STE. 101
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2507
Practice Address - Country:US
Practice Address - Phone:843-402-5283
Practice Address - Fax:843-795-5208
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2016-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC35674207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine