Provider Demographics
NPI:1811359334
Name:BUCHANAN, KENDALL LINER (MD)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:LINER
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PARK AVE SW STE 100
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-2417
Mailing Address - Country:US
Mailing Address - Phone:803-641-0049
Mailing Address - Fax:
Practice Address - Street 1:118 PARK AVE SW STE 100
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-2417
Practice Address - Country:US
Practice Address - Phone:803-641-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD83926207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology