Organization
PROVIDENCE CARDIOLOGY LLC
Active
Other names
Providence Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN L KOENIG (CHIEF FINANCIAL OFFICER)
(803) 254-3278
Entity
Organization
Contact information
Practice address
506 NORTH ST, BAMBERG, SC 29003-1319
(803) 245-6290
(803) 245-6291
Mailing address
2001 LAUREL ST, COLUMBIA, SC 29204-1018
(803) 254-3278
(803) 376-8010
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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