Provider Demographics
NPI:1457795965
Name:GREENE-DUKES, CYNTHIA ANNETTE
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANNETTE
Last Name:GREENE-DUKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ACADEMY STREET
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29590
Mailing Address - Country:US
Mailing Address - Phone:843-355-5533
Mailing Address - Fax:
Practice Address - Street 1:500 ACADEMY STREET
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556
Practice Address - Country:US
Practice Address - Phone:843-355-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator