Individual
GERALD CONRAD BAUKNIGHT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1655 BERNARDIN AVE STE 220, COLUMBIA, SC 29204-2044
(803) 409-7170
(803) 409-7175
Mailing address
PO BOX 935722, ATLANTA, GA 31193-5722
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
17604
SC
207RI0011X
Interventional Cardiology Physician
17604
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17604
SC LICENSE
SC
05
—
176044
—
SC
Enumeration date
05/08/2006
Last updated
08/24/2021
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