Healthcare Provider Details

I. General information

NPI: 1619538477
Provider Name (Legal Business Name): RICHARD DARYL HUNEYCUTT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N SUMTER ST STE 400
SUMTER SC
29150-4971
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 803-934-0810
  • Fax: 803-934-0809
Mailing address:
  • Phone: 803-522-8604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number82285
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: