Individual
KEVIN BLAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
719 OKATIE HWY # 170, OKATIE, SC 29909-3963
(843) 987-7400
Mailing address
PO BOX 357, RIDGELAND, SC 29936-2605
(843) 987-7400
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
83055
SC
208D00000X
General Practice Physician
5101022071
MI
Other
Enumeration date
06/30/2015
Last updated
05/19/2020
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