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NPI Code Detail

MEDICARE: KASSAMO DAYEMO MD

MEDICARE: KASSAMO DAYEMO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician19094SC

General Provider Information

NPI Number : 1811941982
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASSAMO DAYEMO MD
Provider Business Mailing Address
First Line : PO BOX 80631
Second Line :
City : CHARLESTON
State : SC
Zip : 29416-0631
Country : US
Telephone Number : 843-763-0503
Fax Number : 843-763-0514
Provider Business Practice Location Address
First Line : 1606 ASHLEY RIVER RD
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-5902
Country : US
Telephone Number : 843-763-0503
Fax Number : 843-763-0514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2006
Last Update Date : 10/03/2014

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Directions to “ KASSAMO DAYEMO MD” Practice Location

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