Provider Demographics
NPI:1528210887
Name:KADIAN, MANISH (MD)
Entity Type:Individual
Prefix:
First Name:MANISH
Middle Name:
Last Name:KADIAN
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 1:121 PARK CENTRAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6476
Mailing Address - Country:US
Mailing Address - Phone:803-252-9907
Mailing Address - Fax:803-252-9906
Practice Address - Street 1:121 PARK CENTRAL DR
Practice Address - Street 2:SUITE0200
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6476
Practice Address - Country:US
Practice Address - Phone:803-252-9907
Practice Address - Fax:803-252-9906
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC34427207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC38364Medicaid
SC38364Medicaid