Physician Compare National (NPI:1558328732)

HEALTHCARE PROVIDER: STEPHEN FEDERICK DYKE D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1558328732
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416004072
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090416000611
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DYKE
	Individual professional last name
Provider First Name	STEPHEN
	Individual professional first name
Provider Middle Name	FREDERICK
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2520 EVANS ST
	Group Practice or individual's line 1 address
City	NEWBERRY
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	291082940
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420053
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NEWBERRY COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y