Individual
DR. PAUL MCNEELY DEATON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3531 MARY ADER AVE, BLDG. A, CHARLESTON, SC 29414-5896
(843) 744-1669
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7426
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074261
—
SC
01
—
P00648638
RAILROAD MEDICARE ID
SC
01
—
P00982684
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
04/26/2006
Last updated
10/20/2015
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