Provider Demographics
NPI:1124023510
Name:VARNEY, MICHAEL JOHN (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:VARNEY
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 749306
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9306
Mailing Address - Country:US
Mailing Address - Phone:843-663-2220
Mailing Address - Fax:
Practice Address - Street 1:2246 HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-9235
Practice Address - Country:US
Practice Address - Phone:843-663-2220
Practice Address - Fax:843-663-2221
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33319207R00000X, 208D00000X
SC16343207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCB4139OtherMEDCOST
NC01-28700OtherUNITED HEALTHCARE
NC84974OtherBCBS
NC111020136OtherRAILROAD MEDICARE
NC111020136OtherRAILROAD MEDICARE
NC2151519QMedicare PIN