Healthcare Provider Details

I. General information

NPI: 1760477327
Provider Name (Legal Business Name): ROBERT EMMETT MCCARTHY III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 CHARTER DR SUITE 200
COLUMBIA MD
21044-3629
US

IV. Provider business mailing address

10700 CHARTER DR STE 200
COLUMBIA MD
21044-3629
US

V. Phone/Fax

Practice location:
  • Phone: 410-715-0108
  • Fax: 410-995-3681
Mailing address:
  • Phone: 410-715-0108
  • Fax: 410-995-3681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0046300
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: