MEDICARE: DEBRA L MCCARTY DO

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	207Q00000X	Family Medicine Physician	40574	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00D35MC	OTHER	MN	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356341093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA L MCCARTY DO

Provider Business Mailing Address
First Line	:	435 S GROVE ST
Second Line	:	STE 1
City	:	BLUE EARTH
State	:	MN
Zip	:	56013-2604
Country	:	US
Telephone Number	:	507-526-7388
Fax Number	:	507-526-2467

Provider Business Practice Location Address
First Line	:	435 S GROVE ST
Second Line	:	STE 1
City	:	BLUE EARTH
State	:	MN
Zip	:	56013-2604
Country	:	US
Telephone Number	:	507-526-7388
Fax Number	:	507-526-2467

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	07/08/2007

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