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Individual

DR. DIERDRE TANECIA YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
800 E CHEVES ST STE 400, FLORENCE, SC 29506-2649
(843) 777-7341
(843) 777-7345
Mailing address
506 E CHEVES ST STE 202, FLORENCE, SC 29506-2616
(843) 777-7341
(843) 777-7345

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2007-01897
NC
207R00000X
Internal Medicine Physician
Primary
82454
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14704
BCBS
NC
05
5908662
NC
05
NP0935
SC
01
P00448200
RR MEDICARE
NC
Enumeration date
03/29/2007
Last updated
10/26/2023
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