Individual
CHARLES J KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
940 HOLLY ST, ORANGEBURG, SC 29115-4930
(803) 536-2725
(803) 534-3118
Mailing address
940 HOLLY ST, ORANGEBURG, SC 29115-4930
(803) 536-2725
(803) 534-3118
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10325
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0924351
CIGNA
SC
05
—
103257
—
SC
01
—
20065759
FIRST CHOICE
SC
01
—
225643
UNISON
SC
01
—
5056289
AETNA
SC
Enumeration date
07/20/2006
Last updated
04/30/2015
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