Provider Demographics
NPI:1427015155
Name:KAVOLUS, CHRISTOPHER H (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:H
Last Name:KAVOLUS
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 1:35 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4816
Mailing Address - Country:US
Mailing Address - Phone:864-234-7654
Mailing Address - Fax:864-675-1657
Practice Address - Street 1:35 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4816
Practice Address - Country:US
Practice Address - Phone:864-234-7654
Practice Address - Fax:864-675-1657
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14851207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8157OtherMEDICARE PTAN
SC148512Medicaid
SCC70471Medicare UPIN
SCC704718157Medicare PIN