Individual
DR. JESSE WOODROW MCELVEEN JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2039 N MAIN ST, SUMMERVILLE, SC 29483-7821
(843) 871-0433
(843) 871-0433
Mailing address
PO BOX 1247, SUMMERVILLE, SC 29484-1247
(843) 871-0433
(843) 871-0433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2046
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157210
BETTER HEALTH PLAN ID#
RI
01
—
488858
UNITED CONCORDIA ID#
SC
05
—
Z20460
—
SC
01
—
ZA035 3
BCBS SC ID#
SC
05
—
ZA9943
—
SC
Enumeration date
05/03/2006
Last updated
07/09/2007
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