Provider Demographics
NPI:1780034207
Name:DANKOVICH, KINDAL WESSEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KINDAL
Middle Name:WESSEL
Last Name:DANKOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KINDAL
Other - Middle Name:
Other - Last Name:WESSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-797-6328
Mailing Address - Fax:
Practice Address - Street 1:20 MEDICAL RIDGE DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605
Practice Address - Country:US
Practice Address - Phone:864-220-7270
Practice Address - Fax:864-241-9211
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL39736208000000X
SC39736208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics