Durham Russell Maples, D.C.
Individual provider Active NPI Chiropractor · Lugoff, SC
NPI 1285826396 · NPPES record last updated Aug 21, 2007
Key facts
- NPI
- 1285826396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1266 (SC)
- Practice address
- 810 Ridgeway Road
Lugoff, SC 29078-0248 - Phone
- (803) 438-1177
- NPI assigned
- Aug 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1266 | SC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wateree Chiropractic | Chiropractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1266 | SC | Yes |
Addresses
Primary practice location
810 Ridgeway Road
Lugoff, SC 29078-0248
Mailing address
PO Box 248
Lugoff, SC 29078-0248
Phone (803) 438-1177
Other providers in Lugoff, SC
- Kelly Ann Long
- Debra C Lowsky
- Lugoff Family Dentistry, LLC
- Lauren Mackey
- Morgan Lane Magee
- Heza Maria Massey
- Cynthia W May
- James C McAlpine Jr.
- Megan Ann McCoy
- Kathryn Suzanne McGee
All providers in Lugoff, SC · Chiropractor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.