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Organization

PROVIDENCE CARDIOLOGY

Active
Parent organization
PROVIDENCE CARDIOLOGY
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE CARDIOLOGY
Authorized official
KATHLEEN L KOENIG (CFO)
(803) 254-3278
Entity
Organization

Contact information

Practice address
108 PALMETTO PARK BLVD, LEXINGTON, SC 29072-7968
(803) 254-3278
(803) 255-2715
Mailing address
2001 LAUREL ST, COLUMBIA, SC 29204-1018
(803) 254-3278
(803) 255-2715

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Enumeration date
09/13/2013
Last updated
09/13/2013
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