Provider Demographics
NPI:1164428579
Name:MCCAULEY, JEANNE M (MD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:M
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:631 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225-1228
Mailing Address - Country:US
Mailing Address - Phone:410-500-5600
Mailing Address - Fax:410-659-5974
Practice Address - Street 1:315 N CALVERT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3611
Practice Address - Country:US
Practice Address - Phone:410-500-5600
Practice Address - Fax:410-659-5691
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD25438207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D75309Medicare UPIN