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NPI Code Detail

MEDICARE: DR. JEFFERY L DEAL M.D.

MEDICARE: DR. JEFFERY L DEAL M.D.
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
1261QP2300XPrimary Care Clinic/Center12384SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174520068
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFERY L DEAL M.D.
Provider Business Mailing Address
First Line : 1570 SPINNAKER LN
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-9659
Country : US
Telephone Number : 843-766-6082
Fax Number :
Provider Business Practice Location Address
First Line : 1938 CHARLIE HALL BLVD UNIT B
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-6099
Country : US
Telephone Number : 843-442-0227
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 11/25/2013

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Directions to “ DR. JEFFERY L DEAL M.D.” Practice Location

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