Healthcare Provider Details

I. General information

NPI: 1821232471
Provider Name (Legal Business Name): JAMES F. MCNAB MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 RIBAUT RD STE A
PORT ROYAL SC
29935-2008
US

IV. Provider business mailing address

PO BOX 864541
ORLANDO FL
32886-4541
US

V. Phone/Fax

Practice location:
  • Phone: 843-522-7800
  • Fax: 843-524-0378
Mailing address:
  • Phone: 512-583-0205
  • Fax: 512-583-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD29369
License Number StateSC

VIII. Authorized Official

Name: JAMES F MCNAB JR.
Title or Position: MD/OWNER
Credential: MD
Phone: 843-522-7800