Provider Demographics
NPI:1306892252
Name:MCVEY, KYLE (PA)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:MCVEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HEALTHY WAY
Mailing Address - Street 2:SUITE 1120
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-7915
Mailing Address - Country:US
Mailing Address - Phone:864-225-5130
Mailing Address - Fax:864-225-2592
Practice Address - Street 1:100 HEALTHY WAY
Practice Address - Street 2:SUITE 1120
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-7915
Practice Address - Country:US
Practice Address - Phone:864-225-5130
Practice Address - Fax:864-225-2592
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC529208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00110859OtherRR MEDICARE
SC576007863100OtherBCBS OF SC
SC0048PAMedicaid
SCAA47267111Medicare PIN
SC0048PAMedicaid
SCH665317951Medicare PIN
SCS81482Medicare UPIN