Individual
ISMAIL MIKDAT KABAKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. PH.D.
Contact information
Practice address
96 JONATHAN LUCAS ST, CHARLESTON, SC 29425-8900
(843) 830-6729
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-3147
(843) 792-2396
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MMD.61251
SC
Other
Enumeration date
07/19/2018
Last updated
09/28/2018
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