Individual
DR. KAHLIL AHMADI DEMONBREUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, WHNP-BC, ANP-BC
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
APRN 2202
SC
363LW0102X
Women's Health Nurse Practitioner
Primary
APRN 2202
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NPO649
—
SC
Enumeration date
08/03/2006
Last updated
08/24/2023
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