Individual
DR. KRISTINE E. MCCORQUODALE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
206 MEDICAL CIR, SUITE 1B, WEST COLUMBIA, SC 29169-3654
(803) 796-9200
(803) 796-9226
Mailing address
206 MEDICAL CIR, SUITE 1B, WEST COLUMBIA, SC 29169-3654
(803) 796-9200
(803) 796-9226
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20763
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T49061
—
SC
Enumeration date
01/23/2006
Last updated
07/08/2007
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