Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 27797 | SC |
NPI | 1407847296 |
---|---|
Provider Name | Dr. Michael J Lyons |
First Address | Greenwood, SC 29646-2316 |
Second Address | North Charleston, SC 29418-6083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 18/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
277970 | (05) | SC |
I30981 | (02) | SC |