Provider Demographics
NPI:1225094931
Name:VO, KHOA (MD)
Entity Type:Individual
Prefix:
First Name:KHOA
Middle Name:
Last Name:VO
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 1:990 LAKE HUNTER CIR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5426
Mailing Address - Country:US
Mailing Address - Phone:843-881-4117
Mailing Address - Fax:843-881-4155
Practice Address - Street 1:990 LAKE HUNTER CIR
Practice Address - Street 2:SUITE 1A
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5426
Practice Address - Country:US
Practice Address - Phone:843-881-4117
Practice Address - Fax:843-881-4155
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC248922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA055804OtherLICENSE
SC24892OtherLICENSE
SC248921Medicaid
SCAA49069195Medicare UPIN
GA26BDKCJMedicare ID - Type Unspecified
SC248921Medicaid