Healthcare Provider Details

I. General information

NPI: 1992982623
Provider Name (Legal Business Name): MATTHEW RYAN LAYE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105B OMNI DR
SENECA SC
29672-9448
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-482-3157
  • Fax: 864-482-3160
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number23546
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: