| Djb Md Llc | |
|
115 Fairchild St Ste 170 Daniel Island SC 29492-7602 | |
| (803) 339-1563 | |
| (803) 746-7902 |
| Full Name | Djb Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 115 Fairchild St Ste 170, Daniel Island, South Carolina |
| Authorized Official Name and Position | Daniel J. Balog (DIRECTOR) |
| Authorized Official Contact | 8033391563 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Djb Md Llc 115 Fairchild St Ste 170 Daniel Island SC 29492-7602 Ph: (803) 339-1563 | Djb Md Llc 115 Fairchild St Ste 170 Daniel Island SC 29492-7602 Ph: (803) 339-1563 |
| NPI Number | 1366941148 |
|---|---|
| Provider Enumeration Date | 02/07/2018 |
| Last Update Date | 04/10/2025 |
| Certification Date | 04/10/2025 |
| Medicare PECOS PAC ID | 8325467384 |
|---|---|
| Medicare Enrollment ID | O20200924003328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366941148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Donna Clair Orvin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699712539 PECOS PAC ID: 1153222088 Enrollment ID: I20040115000136 |
| Provider Name | David Orvin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700940814 PECOS PAC ID: 4385645563 Enrollment ID: I20070131000303 |
| Provider Name | Piave Pitisci Lake |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316075203 PECOS PAC ID: 3678697281 Enrollment ID: I20100903000425 |
| Provider Name | Daniel John Balog |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710036470 PECOS PAC ID: 4688998263 Enrollment ID: I20150130002282 |
| Provider Name | Stephanie L Price |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487948774 PECOS PAC ID: 7113163601 Enrollment ID: I20160815001282 |
| Provider Name | Meredith Good |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730618679 PECOS PAC ID: 0547531535 Enrollment ID: I20170809003475 |
| Provider Name | Elizabeth L Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447409735 PECOS PAC ID: 7618237215 Enrollment ID: I20180130001186 |
| Provider Name | Haylee Caddell Fiddie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962243782 PECOS PAC ID: 6002354008 Enrollment ID: I20240821000755 |
| Provider Name | Jerry Thompson Stewart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669574687 PECOS PAC ID: 3173045978 Enrollment ID: I20250321001110 |
| Provider Name | Corey Hassell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922593854 PECOS PAC ID: 0244583961 Enrollment ID: I20250520000376 |
Slp Bridge, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 Fairchild St Ste 170, Daniel Island, SC 29492 Phone: 803-339-1563 Fax: 803-746-7902 | |
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