Mccullough, Kevin Michael

Mccullough, Kevin Michael is an individual health care provider with primary practice located at 601 S Sutton Rd Ste 101, Fort Nill SC 29715. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mccullough, Kevin Michael can be contacted via phone (803) 328-6306.

Contact Information

Primary practice address
601 S Sutton Rd Ste 101 Fort Nill SC 29715
Phone: (803) 328-6306
Fax: (803) 909-6451
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-07689 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4394 South Carolina

Profile Details

NPI number 1285147793
LBN Legal business name Mccullough, Kevin Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2017
Last updated Oct 20th, 2023 - about last year

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 1285147793 NPPES
South Carolina MEDICAID 3507PA
South Carolina MEDICAID 1285147793

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