Individual
DR. JOHN COURTENAY MACILWAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 DOUGHTY ST, SUITE 280, CHARLESTON, SC 29403-5736
(843) 769-9450
(843) 769-9450
Mailing address
125 DOUGHTY ST, SUITE 280, CHARLESTON, SC 29403-5736
(843) 769-9450
(843) 769-9450
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101036674
VA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
29539
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295399
—
SC
01
—
P00946935
RAILROAD MEDICARE ID- RSFPN
SC
Enumeration date
09/07/2005
Last updated
08/17/2013
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