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NPI Code Detail

MEDICARE: DR. JOHN COURTENAY MACILWAINE M.D.

MEDICARE: DR. JOHN COURTENAY MACILWAINE M.D.
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
1207X00000XOrthopaedic Surgery Physician0101036674VA
2207XS0106XOrthopaedic Hand Surgery Physician29539SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00946935OTHERSCRAILROAD MEDICARE ID- RSFPN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962496802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN COURTENAY MACILWAINE M.D.
Provider Business Mailing Address
First Line : 125 DOUGHTY ST
Second Line : SUITE 280
City : CHARLESTON
State : SC
Zip : 29403-5736
Country : US
Telephone Number : 843-769-9450
Fax Number : 843-769-9450
Provider Business Practice Location Address
First Line : 125 DOUGHTY ST
Second Line : SUITE 280
City : CHARLESTON
State : SC
Zip : 29403-5736
Country : US
Telephone Number : 843-769-9450
Fax Number : 843-769-9450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 08/17/2013

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