Dr Kenneth E Krzyzaniak, MD | |
823 82nd Pkwy, Myrtle Beach, SC 29572-4607 | |
(843) 449-1010 | |
(843) 497-6171 |
Full Name | Dr Kenneth E Krzyzaniak |
---|---|
Gender | Male |
Speciality | Urology |
Location | 823 82nd Pkwy, Myrtle Beach, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265423479 | NPI | - | NPPES |
771701 | Other | SC | WELLCARE |
890508M | Medicaid | NC | |
GP1418 | Medicaid | SC | |
GP454522 | Medicaid | SC | |
104997 | Medicaid | SC | |
340011957 | Other | SC | RAILROAD MEDICARE |
80023039 | Other | SC | SELECT HEALTH |
P00360560 | Other | SC | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | MD10499 (South Carolina) | Primary |
Entity Name | Atlantic Urology Clinics Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447293790 PECOS PAC ID: 0840296638 Enrollment ID: O20061019000077 |
Mailing Address | Practice Location Address |
---|---|
Dr Kenneth E Krzyzaniak, MD 2234 Colonial Blvd, Managed Care Dept, Fort Myers, FL 33907-1412 Ph: (239) 931-7342 | Dr Kenneth E Krzyzaniak, MD 823 82nd Pkwy, Myrtle Beach, SC 29572-4607 Ph: (843) 449-1010 |
Dr. Abhishek Srivastava, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 823 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-449-1010 | |
Dr. Neal Shore, DR Urology Medicare: Accepting Medicare Assignments Practice Location: 823 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-449-1010 Fax: 843-497-6171 | |
Dr. Lauren Folgosa Cooley, M.D, PH.D Urology Medicare: Medicare Enrolled Practice Location: 823 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-449-1010 | |
Dr. Richard W Young, DR Urology Medicare: Accepting Medicare Assignments Practice Location: 823 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-449-1010 Fax: 843-497-6171 | |
Dr. Bill Hampton Davis, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 7616 Driftwood Dr, Myrtle Beach, SC 29572 Phone: 843-449-0554 Fax: 843-497-4861 | |
Dr. Brian J Roberts, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 823 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-449-1010 Fax: 843-497-6171 |