Healthcare Provider Details
I. General information
NPI: 1487989059
Provider Name (Legal Business Name): DANIEL D KIRCHOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/14/2009
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
125 DOUGHTY ST SUITE 660
CHARLESTON SC
29403-5736
US
IV. Provider business mailing address
PO BOX 751649
CHARLOTTE NC
28275-1649
US
V. Phone/Fax
- Phone: 843-577-7550
- Fax: 843-789-1633
- Phone: 843-789-1620
- Fax: 843-724-2440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | A123941 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | 38367 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: