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Contact Information

KELLY C HARRIS, MD
114 GATEWAY CORPORATE BLVD STE 420
COLUMBIA, SC29203-9785
 Phone: 803-365-8650
 Fax: 803-365-8659
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for KELLY C HARRIS · (Male)

NPI # 1487974283
Status Active
Credentials MD
Entity Individual
Enumeration date 06/03/2010
Last updated 02/22/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • SC License # 61254
  • TN License # 52928
  • SC Medicaid 612545
  • TN Medicaid Q013673
Hospital affiliation(s)
  • PALMETTO HEALTH BAPTIST - (Acute Care)
    TAYLOR AT MARION ST
    COLUMBIA, SC 29220
  • PALMETTO HEALTH RICHLAND - (Acute Care)
    5 RICHLAND MEDICAL PARK
    COLUMBIA, SC 29203
  • SISTERS OF CHARITY PROVIDENCE HOSPITALS - (Acute Care)
    2435 FOREST DR
    COLUMBIA, SC 29204
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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