Provider Demographics
NPI:1124019328
Name:SIMPSON, DANA L (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 ORANGEBURG RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-8914
Mailing Address - Country:US
Mailing Address - Phone:843-261-2600
Mailing Address - Fax:888-839-6837
Practice Address - Street 1:679 ORANGEBURG RD
Practice Address - Street 2:SUITE F
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-8914
Practice Address - Country:US
Practice Address - Phone:843-261-2600
Practice Address - Fax:888-839-6837
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC021419207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC214191Medicaid
SCI36943Medicare UPIN
SC214191Medicaid
SCAA10281403Medicare PIN