Provider Demographics
NPI:1972624484
Name:MCNAB, JAMES FYFFE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FYFFE
Last Name:MCNAB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 751461
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1461
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:1680 RIBAUT RAOD
Practice Address - Street 2:STE A
Practice Address - City:PORT ROYAL
Practice Address - State:SC
Practice Address - Zip Code:29935-2029
Practice Address - Country:US
Practice Address - Phone:843-522-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD293692085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA25803OtherIOWA BOARD OF MEDICAL EXAMINERS
SC29369OtherDEPARTMENT OF LABOR, LICENSING AND REGULATION
SC293694Medicaid
NC2007-00321OtherNORTH CAROLINA MEDICAL BOARD
GA019724OtherCOMPOSITE BOARD OF MEDICAL EXAMINERS
NC2007-00321OtherNORTH CAROLINA MEDICAL BOARD
SCAA38149257Medicare PIN