Individual
MRS. KELLY A KAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 200, COLUMBIA, SC 29203-6882
(803) 296-7846
(803) 296-9699
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2381
SC
363AS0400X
Surgical Physician Assistant
2381
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2262PA
—
SC
Enumeration date
07/02/2015
Last updated
06/10/2021
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