Individual
JOHN MICHAEL KACZMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT197543
PA
207RH0003X
Hematology & Oncology Physician
40321
SC
207RX0202X
Medical Oncology Physician
Primary
40321
SC
390200000X
Student in an Organized Health Care Education/Training Program
MT197543
PA
Other
Enumeration date
05/18/2010
Last updated
03/10/2022
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