Individual
DR. KENNETH M CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2093 HENRY TECKLENBURG DR, SUITE 200, CHARLESTON, SC 29414-5741
(843) 958-2500
(843) 958-2680
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
14386
SC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
14386
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143865
—
SC
01
—
P00727289
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
07/12/2006
Last updated
11/11/2020
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