Provider Demographics
NPI:1568405371
Name:PAVY, MICHAEL DUPRE (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DUPRE
Last Name:PAVY
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:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7951
Mailing Address - Fax:843-777-7981
Practice Address - Street 1:401 E CHEVES ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2615
Practice Address - Country:US
Practice Address - Phone:843-777-7951
Practice Address - Fax:843-777-7981
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7882207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC010038449OtherRAILROAD MEDICARE
SC078828Medicaid
NC8906404Medicaid
SC010038449OtherRAILROAD MEDICARE
SC078828Medicaid