Healthcare Provider Details

I. General information

NPI: 1699888297
Provider Name (Legal Business Name): KURT ALFRED FICHTNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6439 GARNERS FERRY RD DORN VETERANS MEDICAL CENTER
COLUMBIA SC
29209
US

IV. Provider business mailing address

6439 GARNERS FERRY RD DORN VETERANS MEDICAL CENTER
COLUMBIA SC
29209
US

V. Phone/Fax

Practice location:
  • Phone: 803-776-4000
  • Fax:
Mailing address:
  • Phone: 803-776-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number21536
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number21536
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number21536
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number21536
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: