Healthcare Provider Details

I. General information

NPI: 1417904541
Provider Name (Legal Business Name): KATHY L LEHMAN-HUSKAMP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHY L LEHMAN MD

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 04/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 ASHLEY AVE
CHARLESTON SC
29425-8908
US

IV. Provider business mailing address

PO BOX 751461
CHARLOTTE NC
28275-1461
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1414
  • Fax:
Mailing address:
  • Phone: 843-792-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2005006933
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number34328
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036.124328
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: