Basic Information
| Provider Information | |||||||||
| NPI: | 1427053008 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCPHAIL | ||||||||
| FirstName: | SCHUBERT | ||||||||
| MiddleName: | DEAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 401 W DECATUR ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 270251913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365489618 | ||||||||
| FaxNumber: | 3364452227 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 W DECATUR ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 270251913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365489618 | ||||||||
| FaxNumber: | 3364452227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2005 | ||||||||
| LastUpdateDate: | 05/11/2009 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 17591 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 202289C | 01 | NC | MEDICARE PTAN | OTHER | 202289B | 01 | NC | MEDICARE PTAN | OTHER | 8958135 | 05 | NC | MEDICAID |