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Individual

BRIAN W KENDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 395-2200
(803) 536-0998
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 536-0998

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23476
RI
207R00000X
Internal Medicine Physician
Primary
23476
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000060163129
UNISON
SC
01
20039168
FIRST CHOICE
SC
01
4209804
CIGNA
SC
01
7854405
AETNA
SC
05
T77191
SC
Enumeration date
12/16/2005
Last updated
12/07/2009
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