Individual
DR. UDAYAKUMAR KATHAIYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 477-0177
(843) 232-2428
Mailing address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 477-0177
(843) 232-2428
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01053644A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350967
ANTHEM
IN
05
—
200323590
—
IN
Enumeration date
05/19/2006
Last updated
07/02/2010
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