Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | LL41102 | SC |
NPI | 1003344169 |
---|---|
Provider Name | Jordan James Mccarthy |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-8905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2017 |
Last Update Date | 03/09/2020 |