Individual provider Active NPI

Haytham Dimashkieh, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Seneca, SC
National Provider Identifier
1265453260
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
28088 Issued in SC
Practice address
298 Memorial Dr
Seneca, SC 29672-9443
Phone
(864) 885-7120
NPI assigned
Jul 22, 2006
Last updated
Feb 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 28088 SC Primary

Addresses

Primary practice location

298 Memorial Dr
Seneca, SC 29672-9443

Mailing address

PO Box 16285
Greenville, SC 29606-7285
Phone (843) 792-6200

Other identifiers 1

IdentifierTypeStateIssuer
280886MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28088SCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Past Accepting new patients
Pathology Consultants, Inc Anatomic Pathology & Clinical Pathology PastSince Feb 1, 2014 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1265453260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16285",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296067285",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 MEMORIAL DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729443",
            "telephone_number": "864-885-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMASHKIEH",
        "first_name": "HAYTHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "28088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280886",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.