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NPI Code Detail

MEDICARE: MARY J MCCAFFERTY MD

MEDICARE: MARY J MCCAFFERTY MD
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
12084P0800XPsychiatry Physician35059096OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710936075
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY J MCCAFFERTY MD
Provider Business Mailing Address
First Line : 2200 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-1297
Country : US
Telephone Number : 614-752-0333
Fax Number : 614-995-2208
Provider Business Practice Location Address
First Line : 2200 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-1297
Country : US
Telephone Number : 614-752-0333
Fax Number : 614-995-2208
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2006
Last Update Date : 01/06/2011

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Directions to “ MARY J MCCAFFERTY MD” Practice Location

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