MEDICARE: DAVID MICHAEL MCKALIP M.D.

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	83677	GA
2	207T00000X	Neurological Surgery Physician	ME81052	FL
3	207T00000X	Neurological Surgery Physician	33547	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1770588626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MICHAEL MCKALIP M.D.

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/18/2020

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