MEDICARE: DARRYL M SUGAR 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	207RN0300X	Nephrology Physician	21529	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	:	1588679146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARRYL M SUGAR MD

Provider Business Mailing Address
First Line	:	290 APPLEWOOD CENTER PL STE G
Second Line	:	PMB #310
City	:	SENECA
State	:	SC
Zip	:	29678-0930
Country	:	US
Telephone Number	:	864-482-3773
Fax Number	:	864-482-3299

Provider Business Practice Location Address
First Line	:	135 PROFESSIONAL PARK DR
Second Line	:
City	:	SENECA
State	:	SC
Zip	:	29678-2558
Country	:	US
Telephone Number	:	864-482-3773
Fax Number	:	864-482-3299

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SHIRLEY SUGAR
Credential	:
Telephone Number	:	864-482-3773

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	02/11/2008

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