Individual
TERESA MARY KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2601 LAUREL ST STE 120, COLUMBIA, SC 29204-2034
(803) 227-5320
Mailing address
255 ENTERPRISE BLVD, SUITE 250, GREENVILLE, SC 29615-6300
(864) 454-0888
(864) 454-1130
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
279
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002794
—
SC
01
—
110234017
MEDICARE RAILROAD
SC
01
—
57-6007863
BCBS
SC
01
—
576007863
AETNA
SC
Enumeration date
09/20/2006
Last updated
03/07/2023
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