Individual
JEROME F MCCABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4502 RIVERSIDE LANE, MURRELLS INLET, SC 29576-6813
(843) 421-5455
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21192
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016473010001
—
PA
05
—
211924
—
SC
05
—
2648513
—
OH
01
—
34195845111518
TRICARE WEST
—
05
—
7717100
—
SD
01
—
P00267423
RXR MEDICARE
SC
Enumeration date
11/09/2005
Last updated
06/05/2017
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