Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 35047280 | OH |
NPI | 1487648887 |
---|---|
Provider Name | Karen Sharrock Mccoy |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 04/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002408 | (02) | |
0105963000 | MEDICAID (01) | WV |
0498046 | (05) | OH |
64860489 | MEDICAID (01) | KY |