Provider Demographics
NPI:1942286943
Name:MCCARRON, DAVID P (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:MCCARRON
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 1:8536 PALMETTO COMMERCE PKWY
Mailing Address - Street 2:STE 401
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-6700
Mailing Address - Country:US
Mailing Address - Phone:803-536-1951
Mailing Address - Fax:803-536-0998
Practice Address - Street 1:316 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1113
Practice Address - Country:US
Practice Address - Phone:843-724-2450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18794207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20039156OtherFIRST CHOICE
SC576008010-013OtherBCBS
SC5102280OtherAETNA
SC5895983OtherCIGNA
FL092522500OtherMEDICAID
SCT29118Medicaid
SCT29118Medicaid
SCF727997399Medicare ID - Type Unspecified
SC576008010-013OtherBCBS