Healthcare Provider Details

I. General information

NPI: 1649838707
Provider Name (Legal Business Name): MAI NGUYEN DYER MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 PHYSICIANS DR STE 110
CHARLESTON SC
29414-5351
US

IV. Provider business mailing address

WOMEN'S CENTER 1801 SUNSET DRIVE
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 843-740-6700
  • Fax:
Mailing address:
  • Phone: 803-434-4127
  • Fax: 803-434-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberLL82671
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: