Provider Demographics
NPI:1225341290
Name:N K R MEDICAL GROUP INC.
Entity Type:Organization
Organization Name:N K R MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:RYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-348-4603
Mailing Address - Street 1:1107 BELLEVIEW ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-1810
Mailing Address - Country:US
Mailing Address - Phone:803-348-4603
Mailing Address - Fax:
Practice Address - Street 1:1107 BELLEVIEW ST
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-1810
Practice Address - Country:US
Practice Address - Phone:803-348-4603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25198208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious DiseasesGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty