MEDICARE: JOHN KEVIN BAUGH 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	207RC0000X	Cardiovascular Disease Physician	15643	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1942208707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN KEVIN BAUGH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 743904
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-3904
Country	:	US
Telephone Number	:	803-296-7320
Fax Number	:	803-296-7330

Provider Business Practice Location Address
First Line	:	300 PALMETTO HEALTH PKWY STE 400
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212
Country	:	US
Telephone Number	:	803-434-3800
Fax Number	:	803-744-2759

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	08/22/2018

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