MEDICARE: DR. GREGORY J MCCARTHY DPM

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	213E00000X	Podiatrist	00575	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831186865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY J MCCARTHY DPM

Provider Business Mailing Address
First Line	:	2916 HAMILTON BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-2429
Country	:	US
Telephone Number	:	712-255-1621
Fax Number	:	712-255-1389

Provider Business Practice Location Address
First Line	:	2916 HAMILTON BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-2429
Country	:	US
Telephone Number	:	712-255-1621
Fax Number	:	712-255-1389

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	04/28/2008

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