Individual
CHRIS L KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 LADSON RD, SUITE 100, LADSON, SC 29456-4304
(843) 285-2500
(843) 285-2505
Mailing address
3601 LADSON RD, SUITE 100, LADSON, SC 29456-4304
(843) 285-2500
(843) 285-2505
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20842
SC
207RI0011X
Interventional Cardiology Physician
20842
SC
207UN0902X
Nuclear Imaging & Therapy Physician
20842
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060056621
RAILROAD MEDICARE
SC
05
—
208420
—
SC
Enumeration date
05/09/2006
Last updated
04/25/2017
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