Provider Demographics
NPI:1306405741
Name:BARNES, DYLAN MICHAELA (MD)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:MICHAELA
Last Name:BARNES
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:GENERAL SURGERY
Mailing Address - Street 2:2 MEDICAL PARK, STE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-545-5800
Mailing Address - Fax:803-928-0492
Practice Address - Street 1:GENERAL SURGERY
Practice Address - Street 2:2 MEDICAL PARK, STE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-545-5800
Practice Address - Fax:803-928-0492
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL82794208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery