Individual
MRS. KATHLEEN CLAIRE HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
169 ASHLEY AVE, ROOM 202 MAIN HOSPITAL, MSC 333, CHARLESTON, SC 29425
(843) 792-0435
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36895
SC
207R00000X
Internal Medicine Physician
LL36895
SC
208000000X
Pediatrics Physician
LL36895
SC
Other
Enumeration date
06/14/2014
Last updated
07/17/2018
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