Individual
DR. RUSSELL DAVID KITCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2850 TRICOM STREET, NORTH CHARLESTON, SC 29406-9192
(843) 863-1188
(843) 863-8286
Mailing address
2850 TRICOM STREET, NORTH CHARLESTON, SC 29406-9192
(843) 863-1188
(843) 863-8286
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
15299
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152943
—
SC
05
—
GP2380
—
SC
Enumeration date
07/29/2005
Last updated
10/19/2011
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