Provider Demographics
NPI:1316072382
Name:REGEC, STEPHEN P (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:P
Last Name:REGEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2845 E HIGHWAY 76
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-6037
Mailing Address - Country:US
Mailing Address - Phone:843-431-2740
Mailing Address - Fax:843-431-2197
Practice Address - Street 1:2845 E HIGHWAY 76
Practice Address - Street 2:SUITE 3
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-6037
Practice Address - Country:US
Practice Address - Phone:843-431-2740
Practice Address - Fax:843-431-2197
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2011-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SCTL29614207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC296147Medicaid
SCB335319493Medicare PIN
SCB33531Medicare UPIN