Provider Demographics
NPI:1740416262
Name:KERN, SEAN QUIGLEY (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:QUIGLEY
Last Name:KERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-695-6697
Mailing Address - Fax:
Practice Address - Street 1:1301 TAYLOR ST STE 1A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2946
Practice Address - Country:US
Practice Address - Phone:803-434-4790
Practice Address - Fax:803-434-4799
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01082048A208800000X
VA0101265710208800000X
SC92071208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000Medicare UPIN