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Organization
SOUTH CAROLINA ONCOLOGY ASSOC PA
Active
Organization
SOUTH CAROLINA ONCOLOGY ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED J KUDRIK MD (PRESIDENT)
(803) 461-3000
Entity
Organization
Contact information
Practice address
166 STONERIDGE DR, SOUTH CAROLINA ONCOLOGY ASSOC, COLUMBIA, SC 29210
(803) 461-3000
(803) 461-4917
Mailing address
PO BOX 2046, WEST COLUMBIA, SC 29171
(803) 461-3000
(803) 461-4917
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Enumeration date
05/20/2006
Last updated
06/30/2023
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