Provider Demographics
NPI:1134121908
Name:MCCUE, RAYMOND (M D)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:MCCUE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9304 FOREST POINT CIR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4700
Mailing Address - Country:US
Mailing Address - Phone:703-368-1969
Mailing Address - Fax:703-369-4164
Practice Address - Street 1:9304 FOREST POINT CIR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4700
Practice Address - Country:US
Practice Address - Phone:703-368-1969
Practice Address - Fax:703-369-4164
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040699207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6297421Medicaid
VA160000351Medicare ID - Type Unspecified
VA6297421Medicaid