NPI 1043103963

Ethan Michael Kallenberger, MD

Practitioner Otolaryngology Physician Charleston, SC

Practice location

Address: 169 Ashley Ave # Msc333, Charleston, SC 29425-8905
Phone: (843) 792-7365
Mailing address: 169 Ashley Ave Rm 202, Charleston, SC 29425-8905

Registered specialties (2)

Otolaryngology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X Licence LL94805 (SC)

Other Otolaryngology providers in South Carolina →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in South Carolina →

Registry record

NPI: 1043103963
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 May 2025
Record last updated: 30 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.