Provider Demographics
NPI:1558328732
Name:DYKE, STEPHEN FEDERICK (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:FEDERICK
Last Name:DYKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-2940
Mailing Address - Country:US
Mailing Address - Phone:803-276-4422
Mailing Address - Fax:803-276-1592
Practice Address - Street 1:2520 EVANS ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-2940
Practice Address - Country:US
Practice Address - Phone:803-276-4422
Practice Address - Fax:803-276-1592
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC474207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1786Medicaid
SCGP1786Medicaid