Provider Demographics
NPI:1174598221
Name:HUNCIK, KARA BLEVENS (MD)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:BLEVENS
Last Name:HUNCIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 CHARLIE HALL BLVD.
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414
Mailing Address - Country:US
Mailing Address - Phone:843-573-2535
Mailing Address - Fax:843-573-2534
Practice Address - Street 1:2051 CHARLIE HALL BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414
Practice Address - Country:US
Practice Address - Phone:843-573-2535
Practice Address - Fax:843-573-2534
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25977208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC259776Medicaid
SC259776Medicaid