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Organization

CAROLINA KIDNEY SPECIALISTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MUHAMMAD ISLAM M.D. (PRESIDENT)
(803) 256-1137
Entity
Organization

Contact information

Practice address
1655 BERNARDIN AVE, SUITE 200, COLUMBIA, SC 29204-2039
(803) 256-1137
(803) 256-1138
Mailing address
PO BOX 50183, COLUMBIA, SC 29250-0183
(803) 256-1137
(803) 256-1138

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
17200
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DF3940
MEDICARE RR
SC
05
GP4529
SC
Enumeration date
10/18/2006
Last updated
01/02/2008
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