Basic Information
| Provider Information | |||||||||
| NPI: | 1255390191 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCNAIR | ||||||||
| FirstName: | CHARLTON | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1393 CELANESE RD | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297321722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033293103 | ||||||||
| FaxNumber: | 8033252232 | ||||||||
| Practice Location | |||||||||
| Address1: | 1393 CELANESE RD | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297321722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033293103 | ||||||||
| FaxNumber: | 8033252232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | 23464 | SC | X | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207PE0004X | 9701057 | NC | X | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207Q00000X | 23464 | SC | X | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 9701057 | NC | X | Allopathic & Osteopathic Physicians | Family Medicine | 208100000X | 23464 | SC | X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 9701057 | NC | X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2083P0500X | 23464 | SC | X | Allopathic & Osteopathic Physicians | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine | 2083P0500X | 9701057 | NC | X | Allopathic & Osteopathic Physicians | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine |
ID Information
| ID | Type | State | Issuer | Description | D4216 | 01 | MEDCOST | OTHER | 1060A | 01 | NC | BLUE CROSS BLUE SHIELD NC | OTHER | N01057 | 05 | SC | MEDICAID |