Individual
KIM J CORTEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
129 N WASHINGTON ST, SUMTER, SC 29150-4949
(803) 774-1788
(803) 774-9113
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
227311
NY
207R00000X
Internal Medicine Physician
Primary
36528
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365287
—
SC
01
—
SC3047
MEDICARE
SC
Enumeration date
09/22/2006
Last updated
12/06/2018
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