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NPI Code Detail

MEDICARE: DR. DARRYL M SUGAR M.D.

MEDICARE:  DR. DARRYL M SUGAR  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
1207RN0300XNephrology Physician21529SC

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 : 1639172059
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARRYL M SUGAR M.D.
Provider Business Mailing Address
First Line : 290G APPLEWOOD CENTER PLACE
Second Line : PMB #310
City : SENECA
State : SC
Zip : 29678
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 07/08/2007

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Directions to “ DR. DARRYL M SUGAR M.D.” Practice Location

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