Provider Demographics
NPI:1356398424
Name:ZEAGER, MICHAEL E (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:ZEAGER
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 1:3551A RUTHERFORD RD
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-2195
Mailing Address - Country:US
Mailing Address - Phone:864-268-2333
Mailing Address - Fax:864-268-5554
Practice Address - Street 1:3551A RUTHERFORD RD
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2195
Practice Address - Country:US
Practice Address - Phone:864-268-2333
Practice Address - Fax:864-268-5554
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC098860207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2463Medicaid
B92257Medicare UPIN
SC6259Medicare PIN