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NPI Code Detail

MEDICARE: MR. CHARLES A. KOLB MD

MEDICARE:  MR. CHARLES A. KOLB  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician11866SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043213622
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHARLES A. KOLB MD
Provider Business Mailing Address
First Line : PO BOX 968
Second Line :
City : ABBEVILLE
State : SC
Zip : 29620-0968
Country : US
Telephone Number : 864-366-9681
Fax Number : 864-366-5600
Provider Business Practice Location Address
First Line : 901 W GREENWOOD ST
Second Line : SUITE 9
City : ABBEVILLE
State : SC
Zip : 29620-5678
Country : US
Telephone Number : 864-366-9681
Fax Number : 864-366-5600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 01/06/2023

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Directions to “ MR. CHARLES A. KOLB MD” Practice Location

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