Healthcare Provider Details

I. General information

NPI: 1487771473
Provider Name (Legal Business Name): KEVIN SCOTT UREN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/15/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 BROUGHTON ST
ORANGEBURG SC
29115-6648
US

IV. Provider business mailing address

718 BROUGHTON ST
ORANGEBURG SC
29115-6648
US

V. Phone/Fax

Practice location:
  • Phone: 803-531-2888
  • Fax:
Mailing address:
  • Phone: 803-531-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number138
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: