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NPI Code Detail

MEDICARE: DR. MARK JOSEPH MCCARTHY M.D.

MEDICARE: DR. MARK JOSEPH MCCARTHY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist0101046829VA

General Provider Information

NPI Number : 1124023262
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK JOSEPH MCCARTHY M.D.
Provider Business Mailing Address
First Line : 6161 KEMPSVILLE CIR
Second Line : SUITE 215
City : NORFOLK
State : VA
Zip : 23502-3932
Country : US
Telephone Number : 757-455-9603
Fax Number : 757-455-9606
Provider Business Practice Location Address
First Line : 6161 KEMPSVILLE CIR
Second Line : SUITE 215
City : NORFOLK
State : VA
Zip : 23502-3932
Country : US
Telephone Number : 757-455-9603
Fax Number : 757-455-9606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 03/04/2011

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