# DR. KENNETH E KRZYZANIAK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1265423479
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | MD10499 | SC | Yes |

## Other

- **Enumeration date:** 11/04/2005
- **Last updated:** 12/29/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 104997 | — | SC |
| 01 | — | 340011957 | RAILROAD MEDICARE | SC |
| 01 | — | 771701 | WELLCARE | SC |
| 01 | — | 80023039 | SELECT HEALTH | SC |
| 05 | — | 890508M | — | NC |
| 05 | — | GP1418 | — | SC |
| 05 | — | GP454522 | — | SC |
| 01 | — | P00360560 | RAILROAD MEDICARE | SC |