Provider Demographics
NPI:1104833912
Name:MCCAGH, DAIVD PAUL (BS)
Entity Type:Individual
Prefix:MR
First Name:DAIVD
Middle Name:PAUL
Last Name:MCCAGH
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 BISHOP WALSH RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1804
Mailing Address - Country:US
Mailing Address - Phone:301-724-3646
Mailing Address - Fax:
Practice Address - Street 1:101 N CENTRE ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2307
Practice Address - Country:US
Practice Address - Phone:301-724-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist