Provider Demographics
NPI:1750569794
Name:KIMBERLY D NEW MD LLC
Entity type:Organization
Organization Name:KIMBERLY D NEW MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-833-5060
Mailing Address - Street 1:700 PLAZA CIRCLE
Mailing Address - Street 2:STE N KIMBERLY D NEW MD LLC
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-8945
Mailing Address - Country:US
Mailing Address - Phone:864-833-5060
Mailing Address - Fax:864-833-5066
Practice Address - Street 1:700 PLAZA CIRCLE
Practice Address - Street 2:STE N
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-8945
Practice Address - Country:US
Practice Address - Phone:864-833-5060
Practice Address - Fax:864-833-5066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty