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Individual

ROBERT NICHOLAS KISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
411 LOCKMAN RD, ELGIN, SC 29045-8715
(803) 466-0504
Mailing address
PO BOX 24293, COLUMBIA, SC 29224-4293
(803) 466-0504

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
144
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PD1448
SC
Enumeration date
12/07/2005
Last updated
11/08/2007
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