Healthcare Provider Details

I. General information

NPI: 1487610424
Provider Name (Legal Business Name): STEPHEN MICHAEL TUEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 01/05/2025
Certification Date: 01/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 TWO NOTCH RD
COLUMBIA SC
29223-6221
US

IV. Provider business mailing address

7601 TWO NOTCH RD
COLUMBIA SC
29223-6221
US

V. Phone/Fax

Practice location:
  • Phone: 803-419-5345
  • Fax: 803-792-4578
Mailing address:
  • Phone: 803-419-5345
  • Fax: 803-792-4578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number18268
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: