Healthcare Provider Details

I. General information

NPI: 1144233412
Provider Name (Legal Business Name): M CATHLEEN MCCOY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 AMHERST ST STE 3A
WINCHESTER VA
22601-2841
US

IV. Provider business mailing address

1870 AMHERST ST STE 3A
WINCHESTER VA
22601-2841
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-3228
  • Fax: 540-536-3227
Mailing address:
  • Phone: 540-536-3228
  • Fax: 540-536-3227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberFM6673760
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number0101052237
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: