Healthcare Provider Details

I. General information

NPI: 1245422906
Provider Name (Legal Business Name): APRYLE KENNEDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 TAYLOR ST STE 6A
COLUMBIA SC
29201-2953
US

IV. Provider business mailing address

1333 TAYLOR ST STE 6A
COLUMBIA SC
29201-2953
US

V. Phone/Fax

Practice location:
  • Phone: 803-254-2706
  • Fax:
Mailing address:
  • Phone: 803-254-2706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMT198711
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP21930
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: