Provider Demographics
NPI:1215132030
Name:CHANCE, MARIE SUE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:SUE
Last Name:CHANCE
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 1:209 RIVER BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29635-9652
Mailing Address - Country:US
Mailing Address - Phone:864-878-8599
Mailing Address - Fax:
Practice Address - Street 1:303 DACUSVILLE HWY
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-1510
Practice Address - Country:US
Practice Address - Phone:864-855-0853
Practice Address - Fax:864-855-5882
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16361207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine