Provider Demographics
NPI:1144202540
Name:MCCURDY, STEPHEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:MCCURDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE SHIELDS AVE.
Mailing Address - Street 2:TB 168
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95819-2834
Mailing Address - Country:US
Mailing Address - Phone:530-752-8051
Mailing Address - Fax:530-752-3239
Practice Address - Street 1:ONE SHIELDS AVE.
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-8638
Practice Address - Country:US
Practice Address - Phone:530-752-8051
Practice Address - Fax:530-752-3239
Is Sole Proprietor?:No
Enumeration Date:2005-11-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48070207R00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G480700Medicaid
CAA50918Medicare UPIN