Provider Demographics
NPI:1669457016
Name:KAPLAN, RAYMOND SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:SAMUEL
Last Name:KAPLAN
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:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:125 DOUGHTY ST
Practice Address - Street 2:SUITE 280
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5736
Practice Address - Country:US
Practice Address - Phone:843-958-8877
Practice Address - Fax:843-958-8878
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12840207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00784099OtherRAILROAD MEDICARE ID-EFF 5/1/2009
SC128409Medicaid
SCD17525Medicare UPIN
SCD175259223Medicare PIN
SC128409Medicaid
SCD175255551Medicare PIN