Provider Demographics
NPI:1831179621
Name:MYLES, DARLENE MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:MARIE
Last Name:MYLES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2777000
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7700
Mailing Address - Country:US
Mailing Address - Phone:864-560-6000
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:101 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-560-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0651207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20051877OtherSELECT HEALTH
SC89065H7Medicaid
SCP00320243OtherRR MEDICARE
SC189214OtherMEDCOST
SC006513Medicaid
SCP01055821OtherRAILROAD MEDICARE
SCF417398510Medicare PIN
SC20051877OtherSELECT HEALTH
SC89065H7Medicaid