Provider Demographics
NPI:1467430009
Name:CAWTHORNE, JAMES M (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:CAWTHORNE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1730 SAINT JULIAN PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2410
Mailing Address - Country:US
Mailing Address - Phone:803-256-6776
Mailing Address - Fax:803-256-6778
Practice Address - Street 1:3471 W MONTAGUE AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-5938
Practice Address - Country:US
Practice Address - Phone:843-553-2235
Practice Address - Fax:843-553-2275
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC78213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPD0788Medicaid
SCT23647Medicare UPIN
SC3507Medicare ID - Type Unspecified
SCT236478922Medicare Oscar/Certification