Provider Demographics
NPI:1477394252
Name:TONEY, GERALD DREW
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:DREW
Last Name:TONEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WILD FERN CT
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-8499
Mailing Address - Country:US
Mailing Address - Phone:864-546-1563
Mailing Address - Fax:
Practice Address - Street 1:15 WILD FERN CT
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-8499
Practice Address - Country:US
Practice Address - Phone:864-546-1563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator