Provider Demographics
NPI:1154480028
Name:MCLEOD, JOHN F III (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:MCLEOD
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:110 DOCTORS DR
Mailing Address - Street 2:STE B-2
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-7112
Mailing Address - Country:US
Mailing Address - Phone:843-537-9932
Mailing Address - Fax:843-537-9936
Practice Address - Street 1:110 DOCTORS DR
Practice Address - Street 2:STE B-2
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-7112
Practice Address - Country:US
Practice Address - Phone:843-537-9932
Practice Address - Fax:843-537-9936
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2008-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC15756207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC157564Medicaid
SCE39827Medicare UPIN
SCE398270281Medicare PIN