Provider Demographics
NPI:1730861014
Name:BREDBERG, EMMA MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:MARIE
Last Name:BREDBERG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10225 OCEAN HWY # 17
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-6507
Mailing Address - Country:US
Mailing Address - Phone:843-235-3775
Mailing Address - Fax:
Practice Address - Street 1:10225 OCEAN HWY # 17
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-6507
Practice Address - Country:US
Practice Address - Phone:843-235-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC44000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist