Provider Demographics
NPI:1750479598
Name:OBOYLE, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:OBOYLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:209 PATEWOOD DR
Mailing Address - Street 2:STE. 200
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3581
Mailing Address - Country:US
Mailing Address - Phone:864-234-9900
Mailing Address - Fax:864-234-9090
Practice Address - Street 1:209 PATEWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3589
Practice Address - Country:US
Practice Address - Phone:864-234-9900
Practice Address - Fax:864-234-9090
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2014-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC19958207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC199582Medicaid
SCG67581Medicare UPIN