Basic Information
| Provider Information | |||||||||
| NPI: | 1588654925 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARKHAM | ||||||||
| FirstName: | ROY | ||||||||
| MiddleName: | DOUGLASS | ||||||||
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| Credential: | M. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2137 | ||||||||
| Address2: | |||||||||
| City: | SKYLAND | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287762137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282771300 | ||||||||
| FaxNumber: | 8283502174 | ||||||||
| Practice Location | |||||||||
| Address1: | 103 MIDLANDS CT | ||||||||
| Address2: | |||||||||
| City: | WEST COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291693456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037943581 | ||||||||
| FaxNumber: | 8037917286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2005 | ||||||||
| LastUpdateDate: | 02/05/2013 | ||||||||
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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 | 207K00000X | 13846 | SC | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology |
ID Information
| ID | Type | State | Issuer | Description | 20043186 | 01 | SC | SELECT HEALTH | OTHER | 138461 | 05 | SC | MEDICAID | 000000147792 | 01 | SC | UNISON | OTHER |