Provider Demographics
NPI:1821097536
Name:MCGRAW, SCOTT T (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:T
Last Name:MCGRAW
Suffix:
Gender:M
Credentials:MD
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 52
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302-0052
Mailing Address - Country:US
Mailing Address - Phone:866-494-8254
Mailing Address - Fax:
Practice Address - Street 1:507 E LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5502
Practice Address - Country:US
Practice Address - Phone:910-610-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94009242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC56564OtherBC BS
SCN00924Medicaid
NC8956564Medicaid
NCP00332510OtherRAILROAD MEDICARE
G23915Medicare UPIN
NC2220149BMedicare ID - Type Unspecified
NCP00332510OtherRAILROAD MEDICARE