MEDICARE: MITCHELL FOY DILLMAN 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
1	207Q00000X	Family Medicine Physician	14485	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	080028018	OTHER	SC	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1366440356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL FOY DILLMAN M. D.

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	:	864-522-2286
Fax Number	:

Provider Business Practice Location Address
First Line	:	11082 N RADIO STATION RD
Second Line	:
City	:	SENECA
State	:	SC
Zip	:	29678-1142
Country	:	US
Telephone Number	:	864-882-2314
Fax Number	:	864-882-3677

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	05/19/2021

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