Provider Demographics
NPI:1497983399
Name:NEMETH, DANIEL STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:STEPHEN
Last Name:NEMETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:STEPHEN
Other - Last Name:NEMETH
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:929 BOWMAN RD STE 400
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3237
Mailing Address - Country:US
Mailing Address - Phone:843-730-4124
Mailing Address - Fax:843-806-4295
Practice Address - Street 1:929 BOWMAN RD STE 400
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3237
Practice Address - Country:US
Practice Address - Phone:843-730-4124
Practice Address - Fax:843-806-4295
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD37319208100000X
MI4301095051390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0210694OtherCIGNA PROVIDER ID
SC373198Medicaid
SC30225615OtherSELECT HEALTH OF SC PROVIDER ID
SC1500963OtherWELLCARE PROVIER ID
SC9016994OtherAETNA PROVIDER PIN
SC1684256OtherCOVENTRY HEALTHCARE PROVIDER ID
SCGP6337OtherGROUP MEDICAID