Healthcare Provider Details

I. General information

NPI: 1194934018
Provider Name (Legal Business Name): JOHN MICHAEL KURTZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 BLUFFTON PKWY STE 101
BLUFFTON SC
29910-4602
US

IV. Provider business mailing address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

V. Phone/Fax

Practice location:
  • Phone: 843-310-8553
  • Fax:
Mailing address:
  • Phone: 843-310-8553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11135
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4821
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: