Provider Demographics
NPI:1649636390
Name:SLOAN, JEFFREY CLYDE (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CLYDE
Last Name:SLOAN
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 1:1565 BLANCHARD BND
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9658
Mailing Address - Country:US
Mailing Address - Phone:803-328-5828
Mailing Address - Fax:
Practice Address - Street 1:1565 BLANCHARD BND
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9658
Practice Address - Country:US
Practice Address - Phone:803-328-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD15948207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease