Provider Demographics
NPI:1275627077
Name:MAYES, MICHAEL P (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:MAYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HOSPITAL CENTER BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-8700
Mailing Address - Country:US
Mailing Address - Phone:843-342-4455
Mailing Address - Fax:843-342-4435
Practice Address - Street 1:8 HOSPITAL CENTER BLVD STE 210
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-8700
Practice Address - Country:US
Practice Address - Phone:843-342-4455
Practice Address - Fax:843-342-4435
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD19565207R00000X
SC19565207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC195657Medicaid
SCG64931Medicare UPIN
SC195657Medicaid