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General NPI Number Information
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NPI Number | 1538247663
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Entity Type | Individual
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Provider Name | HENRY LEWIS KEARSE III MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 85 SPRINGVIEW LN UNIT C
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8119
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Country | US
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Telephone | 843-876-4400
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Fax | 843-821-2668
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Provider Business Mailing Address
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Address Line | 85 SPRINGVIEW LN UNIT C
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8119
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Country | US
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Telephone | 843-876-4400
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Fax | 843-821-2668
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 13490
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License Number State | SC
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