Provider Demographics
NPI:1699793703
Name:SUGGS, JAMES L (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:SUGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1205 N MAIN ST
Mailing Address - Street 2:PO DRAWER 1030
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-2008
Mailing Address - Country:US
Mailing Address - Phone:843-423-0760
Mailing Address - Fax:843-423-8138
Practice Address - Street 1:1205 N MAIN ST
Practice Address - Street 2:PO DRAWER 1030
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-2008
Practice Address - Country:US
Practice Address - Phone:843-423-0760
Practice Address - Fax:843-423-8138
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC4343207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC043438Medicaid
SCGP5462OtherGROUP MEDICAID
SC043438Medicaid
SCB917415117Medicare PIN
SCB917419493Medicare PIN
SCGP5462OtherGROUP MEDICAID