Individual
KERRY KENNEDY SEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 MEDICAL RIDGE DR, GREENVILLE, SC 29605-4267
(864) 220-7270
(864) 220-7290
Mailing address
300 E MCBEE AVE, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21084
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210845
—
SC
01
—
576007863102
BCBS OF SC ID
SC
01
—
6381895
CIGNA ID
SC
01
—
7454644
AETNA ID
SC
01
—
P00007563
RR MEDICARE
SC
Enumeration date
05/15/2006
Last updated
05/11/2021
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