Individual
DR. MICHAEL JOHN KACKA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3209 COLONIAL DR, PALMETTO HEALTH PREVENTIVE MEDICINE RESIDENCY, COLUMBIA, SC 29203-6930
(803) 434-6113
(803) 434-7231
Mailing address
3209 COLONIAL DR, PALMETTO HEALTH PREVENTIVE MEDICINE RESIDENCY, COLUMBIA, SC 29203-6930
(803) 434-6113
(803) 434-7231
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
MD38381
SC
Other
Enumeration date
11/15/2006
Last updated
09/24/2016
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