Kitch, Russell David

Kitch, Russell David is an sole proprietor health care provider with primary practice located at 2850 Tricom Street , North Charleston SC 29406-9192. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Kitch, Russell David can be contacted via phone (843) 863-1188.

Contact Information

Primary practice address
2850 Tricom Street North Charleston SC 29406-9192
Phone: (843) 863-1188
Fax: (843) 863-8286
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 15299 South Carolina

Profile Details

NPI number 1992705099
LBN Legal business name Kitch, Russell David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2005
Last updated Oct 19th, 2011 - about 15 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 1992705099 NPPES
South Carolina MEDICAID GP2380
South Carolina MEDICAID 152943

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