Provider Demographics
NPI:1679037493
Name:PURCELL, MICHAEL KIRKLAND
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:KIRKLAND
Last Name:PURCELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HOPETOWN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6662
Mailing Address - Country:US
Mailing Address - Phone:843-478-4168
Mailing Address - Fax:
Practice Address - Street 1:55 HOPETOWN RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6662
Practice Address - Country:US
Practice Address - Phone:843-478-4168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies