Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 1621 | SC |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 5101011938 | MI |
NPI | 1013980002 |
---|---|
Provider Name | Ronald James Mcvicar |
First Address | Charleston, SC 29407-4726 |
Second Address | Charleston, SC 29407-4726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 15/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016217 | (05) | SC |