Provider Demographics
NPI:1730283029
Name:WINN, DAVID C (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:C
Last Name:WINN
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 2639
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-2639
Mailing Address - Country:US
Mailing Address - Phone:803-358-6160
Mailing Address - Fax:803-407-4101
Practice Address - Street 1:7035 SAINT ANDREWS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1177
Practice Address - Country:US
Practice Address - Phone:803-358-6160
Practice Address - Fax:803-407-4101
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13733207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC137337Medicaid
E35522Medicare UPIN
SC137337Medicaid