Provider Demographics
NPI:1699728600
Name:LAPEYROLERIE, DARYL ALLYN (MD)
Entity type:Individual
Prefix:
First Name:DARYL
Middle Name:ALLYN
Last Name:LAPEYROLERIE
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 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:
Practice Address - Street 1:200 PATEWOOD DR
Practice Address - Street 2:SUITE B460
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3593
Practice Address - Country:US
Practice Address - Phone:864-454-2226
Practice Address - Fax:864-454-2223
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7422923OtherCIGNA
SC110174884OtherRR MEDICARE
SCT45047Medicaid
SC5043705OtherAETNA
SC576007863032OtherBCBS OF SC
SC576007863115OtherBLUE CHOICE OF SC
SCF54484Medicare UPIN
SCF544846904Medicare PIN
SC576007863115OtherBLUE CHOICE OF SC