Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | JM001547 | MI |
NPI | 1063520997 |
---|---|
Provider Name | Dr. Joseph Mccarthy |
First Address | Clinton Township, MI 48038-1341 |
Second Address | Clinton Township, MI 48038-1341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 22/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3136147 | (05) | MI |
4855051030 | BC (01) | |
U21856 | (02) |