MEDICARE: DR. FERRELL ANN MCCLAIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207P00000X	Emergency Medicine Physician	MD.204072	LA

General Provider Information

NPI Number	:	1912953118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FERRELL ANN MCCLAIN MD

Provider Business Mailing Address
First Line	:	4C LADSON ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29401
Country	:	US
Telephone Number	:	843-259-0272
Fax Number	:

Provider Business Practice Location Address
First Line	:	9298 MEDICAL PLAZA DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29406-9125
Country	:	US
Telephone Number	:	843-876-7081
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	01/15/2016

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