Healthcare Provider Details

I. General information

NPI: 1467430009
Provider Name (Legal Business Name): JAMES M CAWTHORNE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 11/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 W MONTAGUE AVE
NORTH CHARLESTON SC
29418-5938
US

IV. Provider business mailing address

1730 SAINT JULIAN PL
COLUMBIA SC
29204-2410
US

V. Phone/Fax

Practice location:
  • Phone: 843-553-2235
  • Fax: 843-553-2275
Mailing address:
  • Phone: 803-256-6776
  • Fax: 803-256-6778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number78
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: