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General NPI Number Information
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NPI Number | 1518421239
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH MCCARTHY PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/27/2019
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 311 S MCNEIL ST
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City | BURGAW
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State | NC
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Zip | 28425-5015
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Country | US
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Telephone | 910-302-6285
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Fax |
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Provider Business Mailing Address
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Address Line | 5404 SIRIUS DR UNIT 101
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City | WILMINGTON
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State | NC
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Zip | 28405-8455
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Country | US
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Telephone | 631-512-1359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-08814
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License Number State | NC
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