DR. SUDIE E BACK (NPI# 1164478723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164478723 |
| Entity Type | Individual |
| Full Name | DR. SUDIE E BACK |
| Credential | PHD |
| Practice Address |
125 Doughty Street Suite 120 Charleston SC 29425 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 8437925215 |
| Practice Fax Number | 8437920528 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1024 | SC | Behavioral Health & Social Service Providers |
| Street Address |
125 DOUGHTY STREET SUITE 120 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487611505 | George Paul Keogh | Internal Medicine | 125 Doughty Street, Suite 500, Charleston, SC 29403 | 2006-05-01 |
| 1902110372 | Roper Saint Francis Physicians Network | Colon & Rectal Surgery | 125 Doughty Street, Suite 280, Charleston, SC 29403 | 2010-07-28 |
| 1376776815 | William Brett Boring | Physician Assistant | 125 Doughty Street, Suite 680, Charleston, SC 29403-5731 | 2009-09-01 |
| 1396986469 | Roper Saint Francis Physicians Network | Durable Medical Equipment & Medical Supplies | 125 Doughty Street, Suite 660, Charleston, SC 29403 | 2009-03-18 |
| 1205034188 | Robert Bartlett | Anesthesiology | 125 Doughty Street, Suite 420, Charleston, SC 29403-5741 | 2007-07-03 |
| 1821219122 | Eyecare Optical LLC | Technician/Technologist | 125 Doughty Street, Suite 330, Charleston, SC 29403-5740 | 2007-05-02 |
| 1689768335 | Courtney B Cribbs | Physician Assistant | 125 Doughty Street, Suite 680, Charleston, SC 29403-5731 | 2006-10-03 |
| 1558300525 | Charleston Pathology, P.a. | Pathology | 125 Doughty Street, Ste 480, Charleston, SC 29403 | 2006-06-05 |
| 1285692319 | Elizabeth Stelling Christian | Internal Medicine | 125 Doughty Street, Suite 500, Charleston, SC 29403 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083927 | Kimberly Adele Hughes | Psychologist | 310 Cambridge Pointe, Charleston, WV 25309-8596 | 2020-11-04 |
| 1912537424 | Miyuki N. Ege | Psychologist | 333 Laidley St Fl 4e, Charleston, WV 25301-1614 | 2020-01-23 |
| 1487212742 | Alysha Buonerba | Psychologist | 211 King St Ste 206, Charleston, SC 29401-3184 | 2019-06-03 |
| 1336606110 | Ronald Ray Sellers | Psychologist | 2308 Andover Pl, Charleston, IL 61920-3808 | 2019-02-27 |
| 1497212435 | Katherine Elizabeth Bischoff | Psychologist | 388 Huger St, Charleston, SC 29403-4126 | 2019-02-26 |
| 1326512088 | Roper Saint Francis Physicians Network | Psychologist | 2097 Henry Tecklenburg Dr Ste 220, Charleston, SC 29414-5739 | 2019-01-16 |
| 1184191611 | Katherine Knies | Psychologist | 109 Bee St. (116), Charleston, SC 29401-5703 | 2018-11-02 |
| 1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
| 1023527504 | Rosaura Orengo-aguayo | Psychologist | 67 President St # St861, Charleston, SC 29425-5712 | 2017-09-27 |
| 1073062113 | Amanda K. Gilmore | Psychologist | 67 President St # 861, Charleston, SC 29425-5712 | 2016-09-30 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.