Kershaw Urology, LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD12881 Issued in DC

Legal business name

KERSHAW UROLOGY, LLC

Practice address

1327 Haile St
Camden, SC 29020-3001

Phone

(803) 272-0501

NPI assigned

Jan 14, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Augustine O Mireku-Boateng, M.D.

Title

Owner/MD

Phone

(803) 272-0501

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231891200000",
    "number": "1871730796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 HAILE ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203001",
            "telephone_number": "803-272-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 HAILE ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203001",
            "telephone_number": "803-272-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAW UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A",
        "authorized_official_last_name": "MIREKU-BOATENG",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "803-272-0501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "DC",
            "license": "MD12881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kershaw Hospital LLC
• Kershaw Hospital LLC
• Kershaw Hospital LLC
• Kershaw Hospital LLC
• Kershaw Urology LLC
• Kershawhealth
• Kershawhealth (Kershawhealth Primary Care at Camden)
• Kershawhealth
• Kershawhealth (Karesh Long Term Care)
• Kershawhealth (Kershawhealth Surgery Associates)

• Urology Physician in Camden, SC
• Providers in Camden, SC by specialty
• Urology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.