Fred J Kudrik (NPI# 1104807668, PAC ID# 6002867637) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is HEMATOLOGY/ONCOLOGY.
| Nation Provider ID (NPI) | 1104807668 |
| PAC ID by PECOS | 6002867637 |
| Professional Enrollment ID | I20050201000629 |
| Full Name | Fred J Kudrik |
| Organization Legal Name | SOUTH CAROLINA ONCOLOGY ASSOC PA |
| Address |
166 Stoneridge Dr Columbia SC 29210-8239 |
| Phone Number | 8034613000 |
| Gender | M |
| Credential | MD |
| Medical School | CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | HEMATOLOGY/ONCOLOGY |
| Group Practice PAC ID | 6103739024 |
| Number of Group Practice Members | 17 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420086 | PALMETTO HEALTH BAPTIST |
| 420106 | PALMETTO HEALTH BAPTIST PARKRIDGE |
| 420073 | LEXINGTON MEDICAL CENTER |
| 420018 | PALMETTO HEALTH RICHLAND |
| 420026 | PROVIDENCE HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 166 Stoneridge Dr, Columbia, SC 29210-8239 | 8034613000 | SOUTH CAROLINA ONCOLOGY ASSOC PA |
| Organization Legal Name | SOUTH CAROLINA ONCOLOGY ASSOC PA |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jill Maxwell Sullivan | Hematology/oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Robert Joseph Collins Iii | Hematology/oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Brandon M Stone | Radiation Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Leonid Zamdborg | Radiation Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| James A Williams Jr. | Gynecological Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Kevin Gerard Ulloa Blas | Radiation Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| William M Merritt | Gynecological Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Mary Audrey Ackerman | Hematology/oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Chaudry M Mushtaq | Medical Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Kurt D Meyer | Radiation Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Street Address |
166 STONERIDGE DR |
| City | COLUMBIA |
| State | SC |
| Zip | 29210-8239 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jill Maxwell Sullivan | Hematology/oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Robert Joseph Collins Iii | Hematology/oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Brandon M Stone | Radiation Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Leonid Zamdborg | Radiation Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| James A Williams Jr. | Gynecological Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Kevin Gerard Ulloa Blas | Radiation Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| William M Merritt | Gynecological Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Mary Audrey Ackerman | Hematology/oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Chaudry M Mushtaq | Medical Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Kurt D Meyer | Radiation Oncology | South Carolina Oncology Assoc Pa | 166 Stoneridge Dr, Columbia, SC 29210-8239 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Porsche Brown Battle | Qualified Speech Language Pathologist | 3604 Fernadina Rd, Columbia, SC 29210 | |
| Katherine C Davis | Nurse Practitioner | Center for Behavioral Health LLC | 182 Laurelhurst Ave, Columbia, SC 29210-3824 |
| Anil K Juneja | Psychiatry | Center for Behavioral Health LLC | 182 Laurelhurst Ave, Columbia, SC 29210-3824 |
| Charles R Renick | Chiropractic | 4514 Saint Andrews Rd, Columbia, SC 29210-4100 | |
| Holly Sellers | Physical Therapy | Acker Physical Therapy | 144 Leisure Ln, Suite 100, Columbia, SC 29210-4156 |
| Elizabeth S Drye | Physical Therapy | Acker Physical Therapy | 144 Leisure Ln, Suite 100, Columbia, SC 29210-4156 |
| Amy Matzner Acker | Physical Therapy | Acker Physical Therapy | 144 Leisure Ln, Suite 100, Columbia, SC 29210-4156 |
| Mark Coleman Shirley | Chiropractic | 612 St Andrews Rd, Suite 3, Columbia, SC 29210-5120 | |
| Glenn P Zaepfel | Psychologist, Clinical | Barnabas Behavioral Healthcare LLC | 409 Evelyn Dr, Columbia, SC 29210-5212 |
| Maria I Cromer | Clinical Social Worker | Barnabas Behavioral Healthcare LLC | 409 Evelyn Dr, Columbia, SC 29210-5212 |
| Find all physicians in zip 29210 | |||
| City | COLUMBIA |
| Zip Code | 29210 |
| Specialty | HEMATOLOGY/ONCOLOGY |
| City + Specialty | COLUMBIA + HEMATOLOGY/ONCOLOGY |
Please comment or provide details below to improve the information on Fred J Kudrik.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.