Provider Demographics
NPI:1003961319
Name:PIERCEFIELD, DAYNE DOUGLAS (MD)
Entity type:Individual
Prefix:
First Name:DAYNE
Middle Name:DOUGLAS
Last Name:PIERCEFIELD
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 1:8963 ALDERWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-0900
Mailing Address - Country:US
Mailing Address - Phone:678-644-6798
Mailing Address - Fax:
Practice Address - Street 1:12902 USF MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9416
Practice Address - Country:US
Practice Address - Phone:888-663-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA42389207R00000X
FLME61640207R00000X, 208M00000X
NJ25MA08984100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA08984100OtherNJ LICENSE
NJD09905800OtherNJ CDS REGISTRATION
FLME61640OtherFLORIDA BOARD OF MEDICINE
GA42389OtherGEORGIA BOARD OF MEDICINE
NJD09905800OtherNJ CDS REGISTRATION