Provider Demographics
NPI:1528030160
Name:PLAYER, KEITH CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:CHARLES
Last Name:PLAYER
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 1:301 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-3812
Mailing Address - Country:US
Mailing Address - Phone:843-413-6891
Mailing Address - Fax:
Practice Address - Street 1:301 PEARL ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3812
Practice Address - Country:US
Practice Address - Phone:843-413-6891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD19425208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC194257Medicaid
NC89063PJOtherNC MEDICAID
SCG94999Medicare UPIN
SC194257Medicaid