Individual
RHETT COTESWORTH MCCRAW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
890 W FARIS RD, SUITE 580, GREENVILLE, SC 29605-4247
(864) 455-7874
(864) 455-8933
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
11308
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113086
—
SC
01
—
4349832
AETNA
SC
01
—
5135846
CIGNA
SC
01
—
576007863082
BLUE CHOICE OF SC
SC
01
—
P00014369
RR MEDICARE
SC
01
—
P00817206
RR MEDICARE
SC
Enumeration date
06/06/2006
Last updated
07/21/2016
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