Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 12753 | NV |
Y | 207X00000X | Orthopaedic Surgeon | 26146 | SC |
N | 207X00000X | Orthopaedic Surgeon | A 104055 | CA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 26146 | SC |
NPI | 1225119399 |
---|---|
Provider Name | Dr. Heather Mccann Mcintosh |
First Address | Charlotte, NC 28275-1649 |
Second Address | Mt Pleasant, SC 29464-1810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
261460 | (05) | SC |
P00846429 | RAILROAD MEDICARE ID- (01) | SC |