Provider Demographics
NPI:1356338115
Name:HUBACH, KARL S (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:S
Last Name:HUBACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4545 HWY 17 BYPASS
Mailing Address - Street 2:STE. A
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:843-652-5344
Mailing Address - Fax:843-652-0067
Practice Address - Street 1:4545 HWY 17 BYPASS
Practice Address - Street 2:STE. A
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-652-5344
Practice Address - Fax:843-652-0067
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC17611202K00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF10644Medicare UPIN
SC7441Medicare PIN