Individual
AMANDA B. KOGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9330 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9104
(843) 824-3225
(843) 824-3547
Mailing address
9330 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9104
(843) 824-3225
(843) 824-3547
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TL29221
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292212
—
SC
Enumeration date
08/23/2006
Last updated
10/31/2007
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