MEDICARE: MARTIN MCCANN MD

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD.8766	AL
2	207ZC0500X	Cytopathology Physician	MD.8766	AL

General Provider Information

NPI Number	:	1194188300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN MCCANN MD

Provider Business Mailing Address
First Line	:	PO BOX 580
Second Line	:
City	:	FORTSON
State	:	GA
Zip	:	31808-0580
Country	:	US
Telephone Number	:	706-218-8561
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 RIVER RD APT 1106
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-4582
Country	:	US
Telephone Number	:	706-218-8561
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2016
Last Update Date	:	04/04/2016

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Directions to “ MARTIN MCCANN MD” Practice Location

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