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Individual

EDWARD L KATEMBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
151 PEACHWOOD CENTRE DR, SPARTANBURG, SC 29301
(864) 560-9627
(864) 562-5470
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26379
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
190687
MEDCOST
SC
05
263798
SC
01
7971844
AETNA
SC
01
AA03786067
MEDICARE PIN
SC
01
AA03786084
MEDICARE PIN
SC
01
AA03786121
MEDICARE PIN
SC
01
AA0378J577
MEDICARE PIN
SC
01
P0162245
RAILROAD MEDICARE
SC
Enumeration date
08/05/2006
Last updated
01/27/2021
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