Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH RUSSELL GROSSLIGHT, MD JD
Active Sole ProprietorKENNETH RUSSELL GROSSLIGHT, MD JD is a Interventional Vascular Surgery healthcare provider located in WEST COLUMBIA, South Carolina. NPI 1194770115 is currently active in the NPPES registry. Verify at CMS.
Interventional Vascular Surgery · WEST COLUMBIA, SC
Registration Details
- NPI Number
- 1194770115
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 24, 2006 (20.20208762031 yrs)
- Last Updated
- Jul 24, 2015
- Licenses
-
0101036844 (VA)12719 (SC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3227 SUNSET BLVD # FSUITE 102WEST COLUMBIA, SC, 291693201Browse SC providers · Browse ZIP 29169
- Phone
- 8037242336
- Fax
- 8037242317
- Primary Specialty
-
Interventional Vascular Surgery
208VP0014X
- Additional Specialty
- Interventional Vascular Surgery
Other Interventional Vascular Surgery Providers in WEST COLUMBIA, SC
| Name | Credential | NPI |
|---|---|---|
| DR. ROBERT L. DETERS | MD | 1942294004 |
| DR. IVA THIGPEN CHAPPLE | M.D. | 1720047202 |
| CHRISTOPHER A BEAL | DO | 1992115935 |
| JIALIU DAVID LI | M.D. | 1174059182 |
| RUSSELL BINGHAM | PA-C | 1275270654 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.