Provider Demographics
NPI:1912937269
Name:FOX, MICHAEL PATRICK (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PATRICK
Last Name:FOX
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:5336 SUNSET BLVD STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9393
Practice Address - Country:US
Practice Address - Phone:803-567-8900
Practice Address - Fax:803-567-8909
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22321207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCB4743365OtherMEDICARE PIN
SC20T64775Medicaid
SCT64775Medicaid
SC582296052-562OtherBLUE CROSS
SCG228357265Medicare PIN
SC582296052-562OtherBLUE CROSS
G228359365Medicare PIN