Individual
DR. PRINCE KESIDE AMAECHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
322 N PINE ST, SPARTANBURG, SC 29302-1631
(864) 582-5099
(864) 327-1098
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101240360
VA
207R00000X
Internal Medicine Physician
32684
SC
207RN0300X
Nephrology Physician
Primary
32684
SC
208M00000X
Hospitalist Physician
32684
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
326846
—
SC
05
—
5916344
—
NC
05
—
GP4718
—
SC
01
—
P00899815
RAILROAD MEDICARE
SC
01
—
P01079099
RAILROAD MEDICARE
SC
Enumeration date
08/31/2006
Last updated
11/17/2020
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