MEDICARE: DR. GARY A KOCHER M.D.

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
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	570737477	OTHER	SC	TAX ID#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326028846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY A KOCHER M.D.

Provider Business Mailing Address
First Line	:	1516 GREGG ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3530
Country	:	US
Telephone Number	:	803-254-8143
Fax Number	:	803-779-9782

Provider Business Practice Location Address
First Line	:	1516 GREGG ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3530
Country	:	US
Telephone Number	:	803-254-8143
Fax Number	:	803-779-9782

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	09/05/2013

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