Provider Demographics
NPI:1255675054
Name:LINDA C MCLEOD, MD, PA
Entity Type:Organization
Organization Name:LINDA C MCLEOD, MD, PA
Other - Org Name:MCLEOD WOMEN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-432-2540
Mailing Address - Street 1:1009 FAIRLAWN DRIVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020
Mailing Address - Country:US
Mailing Address - Phone:803-432-2540
Mailing Address - Fax:803-432-5431
Practice Address - Street 1:1009 FAIRLAWN DRIVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020
Practice Address - Country:US
Practice Address - Phone:803-432-2540
Practice Address - Fax:803-432-5431
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINDA C MCLEOD, MD, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-16
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC146443Medicaid