Provider Demographics
NPI:1659467751
Name:KFOURY, PETER W (DC DABCI)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:W
Last Name:KFOURY
Suffix:
Gender:M
Credentials:DC DABCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 WAPPOO CREEK DR
Mailing Address - Street 2:STE 103
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2122
Mailing Address - Country:US
Mailing Address - Phone:843-723-1001
Mailing Address - Fax:843-723-8009
Practice Address - Street 1:310 BROAD STREET
Practice Address - Street 2:SUITE 2E
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401
Practice Address - Country:US
Practice Address - Phone:843-723-1001
Practice Address - Fax:843-723-8009
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC779SC111NI0900X
SC779111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist