Individual
SUMODH C. KALATHIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1025 VERDAE BLVD, SUITE A, GREENVILLE, SC 29607-4032
(864) 242-4683
(864) 240-8104
Mailing address
1025 VERDAE BLVD, SUITE A, GREENVILLE, SC 29607-4032
(864) 242-4683
(864) 240-8104
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
30422
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304227
—
SC
01
—
571004971034
BCBS
SC
Enumeration date
06/27/2006
Last updated
05/19/2009
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