Provider Demographics
NPI:1649348046
Name:SIMPSON, DANIEL GABE (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:GABE
Last Name:SIMPSON
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:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7120
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:711 CHESTERFIELD HIGHWAY
Practice Address - Street 2:
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520
Practice Address - Country:US
Practice Address - Phone:843-537-7881
Practice Address - Fax:843-320-3482
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22559207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20032509OtherSELECT HEALTH
SC225599Medicaid
SC22559OtherSTATE LICENSE NUMBER
NC89066P8Medicaid
SC194813OtherUNISON
SCH564405063Medicare PIN
SC194813OtherUNISON
NC89066P8Medicaid