NPI 1194770115

Kenneth Russell Grosslight, MDJD

Practitioner Interventional Pain Medicine Physician West Columbia, SC

Practice location

Address: 3227 Sunset Blvd # F Suite 102, West Columbia, SC 29169-3201
Phone: (803) 724-2336
Fax: (803) 724-2317
Mailing address: 3227-F Sunset Blvd Suite 102, West Columbia, SC 29169-3201

Registered specialties (2)

Interventional Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0014X Licence 12719 (SC)

Other Pain Medicine providers in South Carolina →

Anesthesiology Physician

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 0101036844 (VA)

Other Anesthesiology providers in South Carolina →

Registry record

NPI: 1194770115
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 May 2006
Record last updated: 24 Jul 2015

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.