MOL KY (NPI# 1063607646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063607646 |
| Entity Type | Individual |
| Full Name | MOL KY |
| Credential | DO |
| Practice Address |
333 Revolutionary Trail Fairfax SC 29827 |
| Mailing Address |
Po Box 990 333 Revolutionary Trail Fairfax SC 29827 |
| Practice Telephone | 8036322533 |
| Mailing Telephone | 8036322533 |
| Mailing Fax Number | 8036322451 |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | MD01101TL | SC | Allopathic & Osteopathic Physicians |
| Street Address |
333 REVOLUTIONARY TRAIL |
| City | FAIRFAX |
| State | SC |
| Zip Code | 29827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588623540 | Rebecca Lynn Wilkes | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-03-20 |
| 1588815021 | James Robert Mynatt | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2008-10-02 |
| 1073691002 | Robert M Jones | Family Medicine | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-11-01 |
| 1205840733 | Rossie Reid | Social Worker | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467843078 | We Care Family Resource LLC | Point of Service | 513 Bayshore Dr., Fairfax, SC 29827 | 2015-02-18 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1144370503 | Allendale County Hospital Board | Clinic/Center | 1787 Allendale Fairfax Highway, Fairfax, SC 29827 | 2007-01-10 |
| 1336246677 | Allendale County Hospital Board | Skilled Nursing Facility | 185 Revolutionary Trail, Fairfax, SC 29827 | 2006-09-20 |
| 1881646669 | Shenika L. Marshall-hill | Counselor | 1594 Beaufort Ave. S., Fairfax, SC 29827 | 2006-05-17 |
| 1497745012 | Robert M Haberkorn | Dentist | 1987 Allendale-fairfax Hwy, Fairfax, SC 29827 | 2005-10-25 |
| 1073575171 | Dva Healthcare Renal Care Inc | Clinic/Center | 1241 Boundry St W, Fairfax, SC 29827-3611 | 2006-04-04 |
| 1811384340 | Marie Moore | Registered Nurse | 894 7th St W, Fairfax, SC 29827-4880 | 2015-04-22 |
| 1528309606 | Portereshice Shunta Brabham | Health Maintenance Organization | 345 Amelia St, Fairfax, SC 29827-5967 | 2013-03-14 |
| 1851811988 | Kelly Futch Wall | Speech-Language Pathologist | 1460 Pocotaligo Rd, Fairfax, SC 29827-6826 | 2017-06-20 |
| Find all providers in zip 29827 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255885836 | Dr. Arun K Gupta, PC | General Practice | 10560 Main St Ste 210, Fairfax, VA 22030-7176 | 2016-08-11 |
| 1417380718 | Thomas Edward Byrne | General Practice | 1057 Revolutionary Trl, Fairfax, SC 29827-7127 | 2013-08-10 |
| 1134303423 | Anoushirvan Rezaye Sarraf | General Practice | 4300 Cannon Ridge Ct Unit U, Fairfax, VA 22033-6024 | 2007-12-21 |
| 1629169776 | Catherine S Fehrmann | General Practice | 428 Cascade Dr, Fairfax, CA 94930-2211 | 2006-09-27 |
| 1669804159 | Vip Imed Center | General Practice | 8303 Arlington Blvd, Suite 110, Fairfax, VA 22031-4645 | 2013-08-06 |
| 1760661391 | Fairfax Convenient Care LLC | General Practice | 8301 Arlington Blvd, Suite 100, Fairfax, VA 22031-2902 | 2007-10-31 |
| 1144265216 | Hoda K Makkawi | General Practice | 8301 Arlington Blvd, Suite 100, Fairfax, VA 22031-2902 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912253 | Life Essentials Health Center LLC | General Practice | 1501 N Highway 17 Unit H, Mount Pleasant, SC 29464-3342 | 2020-11-04 |
| 1710591706 | Madhuri Khadka | General Practice | 427 Galbreath Ct, Fort Mill, SC 29708-0176 | 2020-09-07 |
| 1255945754 | Escobedo Advanced Healthcare Solutions LLC | General Practice | 121 Sparkleberry Crossing Rd Ste 200, Columbia, SC 29229-8639 | 2020-09-02 |
| 1306326640 | Orange Cut Rate Drug Store, Inc | General Practice | 1326 Grove Park Dr, Orangeburg, SC 29115 | 2018-08-16 |
| 1841704244 | Modern Concepts, LLC | General Practice | 1808 Second Baxter Xing Ste 108, Fort Mill, SC 29708 | 2017-11-21 |
| 1245744937 | Carolina Healthchoice of Greenville, LLC | General Practice | 274 Commonwealth Dr Ste B, Greenville, SC 29615-4872 | 2017-11-17 |
| 1861937377 | Doctors Care Sc, Pa | General Practice | 8384 Charlotte Highway, Indian Land, SC 29707-6532 | 2016-12-20 |
| 1790138014 | Beaufort-jasper-hampton Comprehensive Health Services Inc. | General Practice | 2210-b Mossy Oaks Rd., Port Royal, SC 29935-1046 | 2016-07-21 |
| 1659726438 | Inspire Medical Services | General Practice | 104 Berkeley Square Ln, Ste 63, Goose Creek, SC 29445-2958 | 2016-04-28 |
| 1609240910 | Eating Recovery Center-the Carolinas | General Practice | 12 Maple Tree Court, Suite 101, Greenville, SC 29615-4079 | 2015-11-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.