Organization
KERSHAWHEALTH
Active
Parent organization
KERSHAWHEALTH
Other names
KERSHAWHEALTH SURGERY ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
KERSHAWHEALTH
Authorized official
MIICHAEL L BUNCH (EVP-COO & CFO)
(803) 713-2496
Entity
Organization
Contact information
Practice address
1102 ROBERTS ST, CAMDEN, SC 29020-3734
(803) 432-7682
Mailing address
1102 ROBERTS ST, CAMDEN, SC 29020-3734
(803) 432-7682
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
HTL0101
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3410
MEDICARE PTAN
SC
05
—
400480
—
SC
Enumeration date
06/10/2014
Last updated
06/10/2014
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