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NPI Code Detail

MEDICARE: DR. MICHAEL J LYONS MD

MEDICARE: DR. MICHAEL J LYONS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207SG0201XClinical Genetics (M.D.) Physician27797SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407847296
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL J LYONS MD
Provider Business Mailing Address
First Line : 101 GREGOR MENDEL CIR
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-2316
Country : US
Telephone Number : 864-941-8100
Fax Number : 864-941-8114
Provider Business Practice Location Address
First Line : 3520 W MONTAGUE AVE STE 104
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29418-6083
Country : US
Telephone Number : 864-941-8100
Fax Number : 864-941-8114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 02/18/2020

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Directions to “ DR. MICHAEL J LYONS MD” Practice Location

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