Individual
UMAKANTHAN SUSEELA KAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC333, CHARLESTON, SC 29425-8905
(843) 792-0435
Mailing address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC333, CHARLESTON, SC 29425-8905
(843) 792-0435
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL82531
SC
208000000X
Pediatrics Physician
LL82531
SC
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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