Individual
STEPHEN CAYELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 ANTREVILLE HWY, IVA, SC 29655-9548
(864) 348-6122
(864) 348-7892
Mailing address
PO BOX 267, IVA, SC 29655-0267
(864) 348-6122
(864) 348-7892
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20356
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00803228A
RAILROAD MEDICARE
—
01
—
080182548
GEORGIA MEDICAID
GA
05
—
T42344
—
SC
Enumeration date
06/21/2006
Last updated
10/06/2015
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