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General NPI Number Information
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NPI Number | 1699840355
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Entity Type | Individual
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Provider Name | NORMAN G MCKOY MD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 10274 LAKE ARBOR WAY SUITE 202
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City | MITCHELLVILLE
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State | MD
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Zip | 20721
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Country | US
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Telephone | 301-336-9065
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Fax | 301-336-6909
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Provider Business Mailing Address
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Address Line | PO BOX 2060
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City | BOWIE
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State | MD
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Zip | 20718-2060
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Country | US
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Telephone | 301-336-9065
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Fax | 301-336-6909
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0035947
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License Number State | MD
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