Individual
DR. KELLIE ANNE AMODEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9291 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9126
(843) 764-1730
(843) 764-1731
Mailing address
9291 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9126
(843) 764-1730
(843) 764-1731
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
86257
SC
2086S0102X
Surgical Critical Care Physician
86257
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2016
Last updated
09/29/2022
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