MEDICARE: DAVID M. MCKALIP MD LLC

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	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1255964318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID M. MCKALIP MD LLC

Provider Business Mailing Address
First Line	:	15 BOWEN CT
Second Line	:
City	:	CARTERSVILLE
State	:	GA
Zip	:	30120-2493
Country	:	US
Telephone Number	:	678-719-8340
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 BOWEN CT
Second Line	:
City	:	CARTERSVILLE
State	:	GA
Zip	:	30120-2493
Country	:	US
Telephone Number	:	678-719-8340
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN /OWNER
Name	:	DAVID M MCKALIP
Credential	:	MD
Telephone Number	:	678-719-8340

Provider Enumeration Date	:	02/18/2020
Last Update Date	:	02/18/2020

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