Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 16202 | SC |
NPI | 1013008705 |
---|---|
Provider Name | Michael S Kitchen |
First Address | Manning, SC 29102-3311 |
Second Address | Manning, SC 29102-3311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F29980 | (02) | SC |