Provider Demographics
NPI:1588654925
Name:MARKHAM, ROY DOUGLASS (M D)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:DOUGLASS
Last Name:MARKHAM
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2137
Mailing Address - Street 2:
Mailing Address - City:SKYLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28776-2137
Mailing Address - Country:US
Mailing Address - Phone:828-277-1300
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:103 MIDLANDS CT
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3456
Practice Address - Country:US
Practice Address - Phone:803-794-3581
Practice Address - Fax:803-791-7286
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13846207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20043186OtherSELECT HEALTH
SC138461Medicaid
SC000000147792OtherUNISON
SCE741536874Medicare PIN
SCE74153Medicare UPIN
SCE741536875Medicare PIN
SC030005311Medicare PIN