Individual
KEVIN MICHAEL DINEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3980 HIGHWAY 9 E, SUITE 340, LITTLE RIVER, SC 29566-8163
(843) 390-8302
(843) 390-8315
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 366-3729
(843) 777-7102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20319
SC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
20319
SC
207RP1001X
Pulmonary Disease Physician
Primary
20319
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639175516
—
NC
05
—
203194
—
SC
Enumeration date
06/24/2005
Last updated
02/02/2021
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