Healthcare Provider Details

I. General information

NPI: 1568598761
Provider Name (Legal Business Name): MICHAEL T. MCCURDY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 OSLER DR
TOWSON MD
21204-7700
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-4442
US

V. Phone/Fax

Practice location:
  • Phone: 410-337-3904
  • Fax:
Mailing address:
  • Phone: 410-328-2454
  • Fax: 410-328-0267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD68279
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD68279
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD68279
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier417547600
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer
# 2
Identifier948228-01 & 02
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerBLUE CROSS/BLUE SHIELD
# 3
IdentifierS062-0378
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerBLUE CROSS REGIONAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: