Pridgen, Kaoru Joan
Pridgen, Kaoru Joan is an sole proprietor health care provider with primary practice located at 1301 Taylor St Ste 5K , Columbia SC 29201-2952. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pridgen, Kaoru Joan can be contacted via phone (839) 200-7805.Contact Information
Primary practice address
1301 Taylor St Ste 5K
Columbia SC 29201-2952
Phone: (839) 200-7805
Fax: (803) 891-7085
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25856 | South Carolina |
Profile Details
| NPI number | 1790755353 |
|---|---|
| LBN Legal business name | Pridgen, Kaoru Joan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Jan 18th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790755353 | NPPES |
| South Carolina | MEDICAID | 258562 |
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