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Organization

SOUTH CAROLINA SLEEP MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSANNAH RAYE KAELIN (MANAGER)
(843) 871-4006
Entity
Organization

Contact information

Practice address
92 SPRINGVIEW LN, SUMMERVILLE, SC 29485-8153
(843) 871-4006
(843) 871-4074
Mailing address
92 SPRINGVIEW LN, SUMMERVILLE, SC 29485-8153
(843) 871-4006
(843) 871-4074

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
SC
207Y00000X
Otolaryngology Physician
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP3738
SC
Enumeration date
07/29/2005
Last updated
07/21/2022
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