Domenic J Demichele,MD,PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

15062 Issued in SC

Legal business name

DOMENIC J DEMICHELE,MD,PC

Practice address

125 S Cashua Dr
Suite a
Florence, SC 29501-4001

Phone

(843) 669-1615

Fax

(843) 669-1613

NPI assigned

Sep 10, 2007

Last updated

Sep 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Domenic J Demichele, M.D., PH.D.

Title

Owner

Phone

(843) 669-1615

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1699960054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 A CASHUA DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-669-1615",
            "fax_number": "843-669-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S CASHUA DR",
            "address_2": "SUITE A",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014001",
            "telephone_number": "843-669-1615",
            "fax_number": "843-669-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMENIC J DEMICHELE,MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "DEMICHELE",
        "authorized_official_first_name": "DOMENIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-669-1615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "SC",
            "license": "15062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Florence, SC
• Providers in Florence, SC by specialty
• Preferred Provider Organization in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.