Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 013913 | ME |
Y | 2080P0208X | Pediatric Infectious Diseases | 013913 | ME |
NPI | 1356375950 |
---|---|
Provider Name | Dr. Carol Mccarthy |
First Address | Scarborough, ME 04074-7609 |
Second Address | Portland, ME 04102-3100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 06/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
274810099 | (05) | ME |
30007595 | (05) | NH |
E21081 | (02) | ME |