Individual
SRINIVASA REDDY KAMATAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-2000
Mailing address
4105 W PELICAN LN, FLORENCE, SC 29501-8453
(313) 506-6048
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39277
SC
207R00000X
Internal Medicine Physician
4301103554
MI
390200000X
Student in an Organized Health Care Education/Training Program
4301103554
MI
Other
Enumeration date
06/30/2013
Last updated
08/15/2023
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