Douglass, Kevin Michael

Douglass, Kevin Michael is an individual health care provider with primary practice located at 853 N Church St Ste 620 , Spartanburg SC 29303-3070. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Douglass, Kevin Michael can be contacted via phone (864) 573-7511.

Contact Information

Primary practice address
853 N Church St Ste 620 Spartanburg SC 29303-3070
Phone: (864) 573-7511
Fax: (864) 560-1690
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 39648 South Carolina

Profile Details

NPI number 1487003943
LBN Legal business name Douglass, Kevin Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2016
Last updated Aug 15th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487003943 NPPES
South Carolina MEDICAID 396486
South Carolina Other SCH6525206

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