MEDICARE: DEBORAH LYNN FYFFE 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
1	207W00000X	Ophthalmology Physician	14309	SC

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

General Provider Information

NPI Number	:	1437108925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH LYNN FYFFE MD

Provider Business Mailing Address
First Line	:	2601 LAUREL ST
Second Line	:	STE 110
City	:	COLUMBIA
State	:	SC
Zip	:	29204
Country	:	US
Telephone Number	:	803-256-7494
Fax Number	:	803-799-0746

Provider Business Practice Location Address
First Line	:	2601 LAUREL ST
Second Line	:	STE 110
City	:	COLUMBIA
State	:	SC
Zip	:	29204
Country	:	US
Telephone Number	:	803-256-7494
Fax Number	:	803-799-0746

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/08/2007

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