Kudrik, Fred J

Kudrik, Fred J is an individual health care provider with primary practice located at 166 Stoneridge Dr , Columbia SC 29210-8239. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Kudrik, Fred J can be contacted via phone (803) 461-3000.

Contact Information

Primary practice address
166 Stoneridge Dr Columbia SC 29210-8239
Phone: (803) 461-3000
Fax: (803) 461-4910
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 22933 South Carolina

Profile Details

NPI number 1104807668
LBN Legal business name Kudrik, Fred J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Nov 12th, 2009 - 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 1104807668 NPPES
South Carolina MEDICAID 229336
South Carolina Other 6275

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