Healthcare Provider Details

I. General information

NPI: 1457583429
Provider Name (Legal Business Name): THURMOND DWAYNE LANIER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 PATRICIA LN STE 102
FORT MILL SC
29708-6608
US

IV. Provider business mailing address

342 PATRICIA LN STE 102
FORT MILL SC
29708-6608
US

V. Phone/Fax

Practice location:
  • Phone: 803-620-1822
  • Fax: 844-612-0190
Mailing address:
  • Phone: 803-620-1822
  • Fax: 844-612-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number588
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number623
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: