Healthcare Provider Details

I. General information

NPI: 1053993675
Provider Name (Legal Business Name): JOSEPH MCCAHON III DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SAINT PAUL PL
BALTIMORE MD
21202-2165
US

IV. Provider business mailing address

301 SAINT PAUL PL
BALTIMORE MD
21202-2165
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9000
  • Fax:
Mailing address:
  • Phone: 410-332-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberH0106944
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: