Individual
MICHAEL JOHN KISSENBERTH
Active
Individual
MICHAEL JOHN KISSENBERTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
27259
SC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
27259
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272591
—
SC
01
—
576007863133
BLUE CHOICE OF SC
SC
01
—
576007863158
BCBS OF SC
SC
01
—
7359182
CIGNA
SC
01
—
7422707
AETNA
SC
01
—
P00271214
RR MEDICARE
SC
Enumeration date
05/25/2006
Last updated
08/01/2025
Update your record
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