Michael John Kissenberth
Orthopaedic Surgeon Sports Medicine Orthopaedic Surgeon
200 Patewood Dr Ste C100
Greenville
, South Carolina 29615-6322
Michael John Kissenberth
Orthopaedic Surgeon Sports Medicine Orthopaedic Surgeon
200 Patewood Dr Ste C100
Greenville
, South Carolina 29615-6322
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About
Features
Specialties
- Orthopaedic Surgeon
- Sports Medicine Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Michael John Kissenberth
- 300 E Mcbee Ave Fl 4
- Greenville, SC
- Zip : 29601-2842
- Phone :
Second Address
- Michael John Kissenberth
- 200 Patewood Dr Ste C100
- Greenville, SC
- Zip : 29615-6322
- Fax : (864) 454-8265
- Phone : (864) 454-7422
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgeon | 27259 | SC |
| Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 27259 | SC |
National Provider Identifier
| NPI | 1184670994 |
|---|---|
| Provider Name | Michael John Kissenberth |
| First Address | Greenville, SC 29601-2842 |
| Second Address | Greenville, SC 29615-6322 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/05/2006 |
| Last Update Date | 06/05/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 272591 | (05) | SC |
| 576007863133 | BLUE CHOICE OF SC (01) | SC |
| 576007863158 | BCBS OF SC (01) | SC |
| 7359182 | CIGNA (01) | SC |
| 7422707 | AETNA (01) | SC |
| I23846 | (02) | SC |
| P00271214 | RR MEDICARE (01) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.