Healthcare Provider Details

I. General information

NPI: 1467426650
Provider Name (Legal Business Name): WILLIAM CAMPBELL MCLAIN III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 GERVAIS ST SUITE 200
COLUMBIA SC
29201-3047
US

IV. Provider business mailing address

700 GERVAIS ST SUITE 200
COLUMBIA SC
29201-3047
US

V. Phone/Fax

Practice location:
  • Phone: 803-788-4762
  • Fax:
Mailing address:
  • Phone: 803-788-4762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number9060
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: