Healthcare Provider Details

I. General information

NPI: 1750355590
Provider Name (Legal Business Name): LINDA C MCLEOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 HIGHWAY 1 S STE 500
LUGOFF SC
29078-8966
US

IV. Provider business mailing address

PO BOX 23321
NEW YORK NY
10087-3321
US

V. Phone/Fax

Practice location:
  • Phone: 803-438-0825
  • Fax: 803-438-0817
Mailing address:
  • Phone: 803-438-0825
  • Fax: 803-438-0817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number14644
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier17503555900
Identifier TypeOTHER
Identifier StateSC
Identifier IssuerNPI
# 2
Identifier146443
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: