Individual
DR. CHARLES MIDDLETON MCKENZIE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1409 DEVINE ST, COLUMBIA, SC 29208-0001
(803) 777-3175
Mailing address
1409 DEVINE ST, COLUMBIA, SC 29208-0001
(803) 777-3175
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
SC10824
SC
Other
Enumeration date
01/19/2006
Last updated
07/08/2007
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