Provider Demographics
NPI:1427275437
Name:NAYAK, JAY B (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:B
Last Name:NAYAK
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 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-512-4580
Mailing Address - Fax:864-512-4585
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:CANCER CENTER 3RD FLOOR
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-4580
Practice Address - Fax:864-512-4585
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097997207RH0003X
SC39610207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC396100Medicaid
MI1427275437Medicaid
N97770004Medicare PIN
SCSC87607111Medicare PIN
MIM74750416Medicare PIN