1497983399 NPI number — DANIEL STEPHEN NEMETH MD

Table of content: DANIEL STEPHEN NEMETH MD (NPI 1497983399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497983399 NPI number — DANIEL STEPHEN NEMETH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEMETH
Provider First Name:
DANIEL
Provider Middle Name:
STEPHEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NEMETH
Provider Other First Name:
DANIEL
Provider Other Middle Name:
STEPHEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
JR.
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1497983399
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
929 BOWMAN RD STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT PLEASANT
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29464-3237
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-730-4124
Provider Business Mailing Address Fax Number:
843-806-4295

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
929 BOWMAN RD STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT PLEASANT
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29464-3237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-730-4124
Provider Business Practice Location Address Fax Number:
843-806-4295
Provider Enumeration Date:
06/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  MD37319 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0210694 . This is a "CIGNA PROVIDER ID" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 373198 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30225615 . This is a "SELECT HEALTH OF SC PROVIDER ID" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 1500963 . This is a "WELLCARE PROVIER ID" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 9016994 . This is a "AETNA PROVIDER PIN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 1684256 . This is a "COVENTRY HEALTHCARE PROVIDER ID" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: GP6337 . This is a "GROUP MEDICAID" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




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