Provider Demographics
NPI:1891780052
Name:WASHINGTON, TONYA RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:RENEE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:700 GARLINGTON RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2168
Mailing Address - Country:US
Mailing Address - Phone:864-520-8799
Mailing Address - Fax:864-214-0605
Practice Address - Street 1:700 GARLINGTON RD UNIT E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5564
Practice Address - Country:US
Practice Address - Phone:864-520-8799
Practice Address - Fax:864-214-0605
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20-T6531207Q00000X
SC22412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC4964H888OtherMEDICARE PIN
SCT65319Medicaid
SCH324048887Medicare PIN
SC5050Medicare PIN
SCH32404Medicare UPIN
SC9159Medicare PIN
SC8887Medicare PIN