Healthcare Provider Details

I. General information

NPI: 1811525850
Provider Name (Legal Business Name): MELISSA JEAN MCCARTHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 SAINT PAUL ST
BALTIMORE MD
21202-2123
US

IV. Provider business mailing address

345 SAINT PAUL ST
BALTIMORE MD
21202-2123
US

V. Phone/Fax

Practice location:
  • Phone: 508-471-0410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0107238
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: