Provider Demographics
NPI:1568506483
Name:MCCOY, R. MAXIE (MD)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:MAXIE
Last Name:MCCOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:75 HARBOR CLUB DR
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-6128
Mailing Address - Country:US
Mailing Address - Phone:843-237-2672
Mailing Address - Fax:843-237-0369
Practice Address - Street 1:116 BASKERVILL DR
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-6013
Practice Address - Country:US
Practice Address - Phone:843-237-2672
Practice Address - Fax:843-237-0369
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC4696208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4696OtherMEDICAL LICENSE
SC4696OtherMEDICAL LICENSE