MEDICARE: DEBORAH GILL MCCARTHY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	225100000X	Physical Therapist	15427	MD

General Provider Information

NPI Number	:	1245853647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH GILL MCCARTHY

Provider Business Mailing Address
First Line	:	212 HODGES LN
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12041 BOURNEFIELD WAY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7907
Country	:	US
Telephone Number	:	301-592-4400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2020
Last Update Date	:	05/20/2020

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