Individual
DR. KURT L GANDENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6704 WHITE HORSE RD, GREENVILLE, SC 29611-2504
(864) 294-1392
(864) 294-0424
Mailing address
1818 HENDERSON ST, COLUMBIA, SC 29201-2619
(803) 782-4278
(803) 782-3445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14391
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14391
—
SC
Enumeration date
05/31/2006
Last updated
09/16/2009
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