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General NPI Number Information
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NPI Number | 1699654798
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Entity Type | Organization
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Legal Business Name | KAIBERG, LLC
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 232 BENT HOLLY DR
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City | COLUMBIA
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State | SC
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Zip | 29209
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Country | US
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Telephone | 443-812-5989
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Fax |
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Provider Business Mailing Address
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Address Line | 9 MARSH CREEK DR
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City | MAULDIN
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State | SC
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Zip | 29662-3150
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Country | US
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Telephone | 646-546-4359
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ERIC HANS GRUENBERGER
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Credential | MD
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Telephone | 443-812-5989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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