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NPI Code Detail

MEDICARE: SAMUEL LEE DICKEY MD

MEDICARE: SAMUEL LEE DICKEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0200XCritical Care Medicine (Internal Medicine) Physician89893SC
2207RP1001XPulmonary Disease Physician89893SC

General Provider Information

NPI Number : 1124557665
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL LEE DICKEY MD
Provider Business Mailing Address
First Line : 300 E MCBEE AVE FL 4
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2842
Country : US
Telephone Number : 864-522-8603
Fax Number :
Provider Business Practice Location Address
First Line : 200 PATEWOOD DR STE B300
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-6338
Country : US
Telephone Number : 864-454-4200
Fax Number : 864-454-4205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 12/05/2025

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Directions to “ SAMUEL LEE DICKEY MD” Practice Location

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