Organization
ROPER SAINT FRANCIS PHYSICIANS NETWORK
Active
Other names
John C. MacIlwaine, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS BOWLING (VP RSFPN)
(843) 724-2903
Entity
Organization
Contact information
Practice address
2097 HENRY TECKLENBURG DR, SUITE 218 WEST, CHARLESTON, SC 29414-5740
(843) 769-9450
(843) 769-9451
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
SC
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP0704
RAILROAD MEDICARE GROUP PTAN
SC
05
—
GP5386
—
SC
Enumeration date
03/30/2010
Last updated
09/17/2010
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