Provider Demographics
NPI:1174696454
Name:DANZEY, TOYA J (MD)
Entity type:Individual
Prefix:MS
First Name:TOYA
Middle Name:J
Last Name:DANZEY
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:P.O. BOX 2585
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29551-2585
Mailing Address - Country:US
Mailing Address - Phone:843-383-8889
Mailing Address - Fax:843-383-8868
Practice Address - Street 1:122 W. COLLEGE AVENUE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4114
Practice Address - Country:US
Practice Address - Phone:843-383-8889
Practice Address - Fax:843-383-8868
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16915174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3854Medicaid
SC7888Medicare ID - Type Unspecified
SCF94831Medicare UPIN