Provider Demographics
NPI:1497733794
Name:KULZE, JOHN C III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:KULZE
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2270 ASHLEY CROSSING DR
Mailing Address - Street 2:STE 100
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414
Mailing Address - Country:US
Mailing Address - Phone:843-556-2357
Mailing Address - Fax:843-556-0350
Practice Address - Street 1:2270 ASHLEY CROSSING DR
Practice Address - Street 2:STE 100
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414
Practice Address - Country:US
Practice Address - Phone:843-556-2357
Practice Address - Fax:843-556-0350
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
SC13052207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA6314Medicaid
F53088Medicare UPIN
1502Medicare ID - Type Unspecified