Provider Demographics
NPI:1023371044
Name:LOADER, KENT BRYCE (MD)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:BRYCE
Last Name:LOADER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-1209
Mailing Address - Country:US
Mailing Address - Phone:843-652-8220
Mailing Address - Fax:843-527-7080
Practice Address - Street 1:9699 OCEAN HWY
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585
Practice Address - Country:US
Practice Address - Phone:843-237-4296
Practice Address - Fax:843-237-0495
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC34837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC34837OtherMEDICAL LICENSE