MEDICARE: VERONICA ANN 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	174400000X	Specialist	2601001069	MI

General Provider Information

NPI Number	:	1396133153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA ANN MCCARTHY

Provider Business Mailing Address
First Line	:	66 HILLTOP LN
Second Line	:
City	:	AUGUSTA
State	:	MI
Zip	:	49012-9502
Country	:	US
Telephone Number	:	269-491-0649
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 HILLTOP LN
Second Line	:
City	:	AUGUSTA
State	:	MI
Zip	:	49012-9502
Country	:	US
Telephone Number	:	269-491-0649
Fax Number	:

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

Provider Enumeration Date	:	01/02/2015
Last Update Date	:	01/02/2015

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Directions to “ VERONICA ANN MCCARTHY ” Practice Location

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