Provider Demographics
NPI:1144292459
Name:CLAYTON, STEVEN BRIAN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:BRIAN
Last Name:CLAYTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:STE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6306
Mailing Address - Fax:
Practice Address - Street 1:890 W FARIS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4253
Practice Address - Country:US
Practice Address - Phone:864-455-2888
Practice Address - Fax:864-455-2885
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2015-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36833207Q00000X
SC32211207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC322118Medicaid
SCSC64877951Medicare PIN
TN3879195Medicaid
H72605Medicare UPIN
TN38791991Medicare PIN
SCPENDINGMedicaid
TNP00069460Medicare PIN