Individual
DR. KRISTINA P HURSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 GATEWAY CORNERS PARK, SUITE 101, COLUMBIA, SC 29203-8906
(803) 865-2122
Mailing address
PO BOX 896239, CHARLOTTE, NC 28289-6239
(803) 865-2122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31369
SC
207R00000X
Internal Medicine Physician
M0762
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M0762
STATE LICENSE #
TX
01
—
P00382491
RAILROAD MEDICARE PTAN
—
Enumeration date
05/16/2006
Last updated
07/21/2022
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