Individual
DANIEL KASSAYE GAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1866 RAOUL WALLENBERG BLVD, SUITE B, CHARLESTON, SC 29407-3545
(843) 766-6646
(843) 766-6646
Mailing address
PO BOX 80054, CHARLESTON, SC 29416-0054
(843) 766-6646
(843) 766-6640
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
22070
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290013912
MEDICARE ID-TYPE UNSPECIFIED/MEDICARE(RAILROAD)
SC
05
—
GP3435
—
SC
Enumeration date
01/31/2006
Last updated
03/04/2014
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