Provider Demographics
NPI:1386605285
Name:FLOYD, DEAN A (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:A
Last Name:FLOYD
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 3788
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29230-3788
Mailing Address - Country:US
Mailing Address - Phone:803-733-5969
Mailing Address - Fax:803-217-0266
Practice Address - Street 1:1115 STATE ST
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-4342
Practice Address - Country:US
Practice Address - Phone:803-939-0174
Practice Address - Fax:803-217-0282
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC088372Medicaid
SCD181674350Medicare PIN
SCD18167Medicare UPIN