Basic Information
| Provider Information | |||||||||
| NPI: | 1497917900 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MARSHALL N. KALINSKY, D.P.M. | ||||||||
| LastName: | |||||||||
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| Credential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1611 SAVANNAH HWY | ||||||||
| Address2: | SUITE A | ||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294072254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437661632 | ||||||||
| FaxNumber: | 8437639430 | ||||||||
| Practice Location | |||||||||
| Address1: | 1611 SAVANNAH HWY | ||||||||
| Address2: | SUITE A | ||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294072254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437661632 | ||||||||
| FaxNumber: | 8437639430 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2008 | ||||||||
| LastUpdateDate: | 07/22/2008 | ||||||||
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| AuthorizedOfficialLastName: | PYE | ||||||||
| AuthorizedOfficialFirstName: | KERRY | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8437661632 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 0054 | SC | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | DE2775 | 01 | SC | MEDICAID DME | OTHER | PD0546 | 05 | SC | MEDICAID |