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Individual

MR. RICHARD BLAKE KLINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2767 CULTRA RD, CONWAY, SC 29526-3716
(843) 438-8470
(843) 438-8480
Mailing address
2767 CULTRA RD, CONWAY, SC 29526-3716
(843) 438-8470
(843) 438-8480

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
20364
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
20364
SC
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
203648
SC
Enumeration date
07/17/2006
Last updated
02/24/2021
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