Individual
DR. THOMAS KENNETH KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
37448
SC
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
MD20912
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150949
—
OR
Enumeration date
08/02/2006
Last updated
11/17/2020
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