Provider Demographics
NPI:1841265220
Name:DE HAVEN, RUTH SCHIRMER (MD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:SCHIRMER
Last Name:DE HAVEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1249A SAVANNAH HWY
Mailing Address - Street 2:ST. ANDREWS MEDICAL, INC
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7826
Mailing Address - Country:US
Mailing Address - Phone:843-763-2000
Mailing Address - Fax:843-763-2325
Practice Address - Street 1:1249A SAVANNAH HWY
Practice Address - Street 2:ST. ANDREWS MEDICAL, INC
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7826
Practice Address - Country:US
Practice Address - Phone:843-763-2000
Practice Address - Fax:843-763-2325
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16710208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTL6836Medicaid
SCTL6836Medicaid