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Individual

DR. VIRGIL J KENNEDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169
(803) 791-2000
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1084
SC
207L00000X
Anesthesiology Physician
DO 1523
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
79686134
UFID
FL
Enumeration date
11/02/2006
Last updated
11/09/2020
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