Provider Demographics
NPI:1972291490
Name:PYE, SYDNIE (PA)
Entity Type:Individual
Prefix:
First Name:SYDNIE
Middle Name:
Last Name:PYE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 FOREST DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2371
Mailing Address - Country:US
Mailing Address - Phone:803-779-3263
Mailing Address - Fax:803-779-3207
Practice Address - Street 1:2611 FOREST DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2371
Practice Address - Country:US
Practice Address - Phone:803-779-3263
Practice Address - Fax:803-779-3207
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMPA.4704207LP2900X
SC4704PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine