Provider Demographics
NPI:1801843529
Name:NAIRN, DANA MAIRI (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MAIRI
Last Name:NAIRN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7430 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2903
Mailing Address - Country:US
Mailing Address - Phone:839-200-7810
Mailing Address - Fax:803-891-7085
Practice Address - Street 1:1931 BULL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2560
Practice Address - Country:US
Practice Address - Phone:839-200-7822
Practice Address - Fax:803-891-7085
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC021212208M00000X
SC21212207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC212120Medicaid
SC212120Medicaid
SCH783019615Medicare PIN
SCH783018165Medicare ID - Type Unspecified