Healthcare Provider Details

I. General information

NPI: 1891875985
Provider Name (Legal Business Name): MOLLY MCCARTHY WALSH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOLLY M MCCARTHY

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2170 MIDLAND RD
SOUTHERN PINES NC
28387-2999
US

IV. Provider business mailing address

230 E DAY RD STE 100
MISHAWAKA IN
46545-3408
US

V. Phone/Fax

Practice location:
  • Phone: 910-295-2100
  • Fax: 910-295-3625
Mailing address:
  • Phone: 574-271-3939
  • Fax: 574-271-3941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number200400616
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2004-00616
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number01085122A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: