Individual
STACIE J BOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
811 WEST MAIN STREET, STE 207, LEXINGTON, SC 29072
(803) 358-6420
(803) 358-6450
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27110
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271100
—
SC
01
—
P00127681
RR MEDICARE
—
Enumeration date
07/21/2006
Last updated
10/13/2020
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