MEDICARE: NORMAN G. MCKOY MD & ASSOCIATES PA

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	D35947	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0733-0001	OTHER	DC	BLUECROSS BLUESHIELD-DC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	06980	OTHER	MD	AMERICAID
4	7946	OTHER	MD	BLUECROSS BLUESHIELD OF MARYLAND

General Provider Information

NPI Number	:	1801047055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORMAN G. MCKOY MD & ASSOCIATES PA

Provider Business Mailing Address
First Line	:	10274 LAKE ARBOR WAY
Second Line	:	SUITE 202
City	:	MITCHELLVILLE
State	:	MD
Zip	:	20721-3146
Country	:	US
Telephone Number	:	301-336-9065
Fax Number	:	301-336-6909

Provider Business Practice Location Address
First Line	:	10274 LAKE ARBOR WAY
Second Line	:	SUITE 202
City	:	MITCHELLVILLE
State	:	MD
Zip	:	20721-3146
Country	:	US
Telephone Number	:	301-336-9065
Fax Number	:	301-336-6909

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. NORMAN G. MCKOY
Credential	:	M.D.
Telephone Number	:	301-336-9065

Provider Enumeration Date	:	10/07/2008
Last Update Date	:	08/07/2014

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