Healthcare Provider Details

I. General information

NPI: 1467980292
Provider Name (Legal Business Name): KELLY O'LEARY KAZMIERSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY MORGAN O'LEARY MD

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 OKATIE HWY
OKATIE SC
29909-3963
US

IV. Provider business mailing address

721 OKATIE HWY
OKATIE SC
29909-3963
US

V. Phone/Fax

Practice location:
  • Phone: 843-987-7400
  • Fax:
Mailing address:
  • Phone: 843-987-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number90901
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number309931
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD472658
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: