Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 29966 | SC |
NPI | 1003013616 |
---|---|
Provider Name | Kathleen Valeska Woschkolup |
First Address | Atlanta, GA 30374-3294 |
Second Address | Greenville, SC 29615-6938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 01/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
299661 | (05) | SC |