| Dr Dwayne J Livigni, DO | |
|
2829 E Highway 76, Mullins, SC 29574-6035 | |
| (843) 661-6215 | |
| (828) 360-3080 |
| Full Name | Dr Dwayne J Livigni |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Location | 2829 E Highway 76, Mullins, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982655262 | NPI | - | NPPES |
| 8Q6531 | Other | NY | EMPIRE BC |
| 001005207 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 000520 (Connecticut) | Secondary |
| 207L00000X | Anesthesiology | DO1614 (South Carolina) | Primary |
| Entity Name | Coastal Anesthesia Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609813179 PECOS PAC ID: 1850295650 Enrollment ID: O20031124000145 |
| Entity Name | Florence Surgery & Laser Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912959560 PECOS PAC ID: 0042102428 Enrollment ID: O20040416000093 |
| Entity Name | Beach Anesthesia, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215061429 PECOS PAC ID: 6103924014 Enrollment ID: O20070530000620 |
| Entity Name | Medstream Anesthesia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649616160 PECOS PAC ID: 7416198049 Enrollment ID: O20140304001021 |
| Entity Name | Atlantic Coast Anesthesia Services Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932641313 PECOS PAC ID: 3971887167 Enrollment ID: O20170308000291 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Dwayne J Livigni, DO 3100 Spring Forest Rd, Suite 130, Raleigh, NC 27616-2880 Ph: (919) 882-0705 | Dr Dwayne J Livigni, DO 2829 E Highway 76, Mullins, SC 29574-6035 Ph: (843) 661-6215 |