Provider Demographics
NPI:1164579777
Name:MCNABB, MCKENDREE EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:MCKENDREE
Middle Name:EUGENE
Last Name:MCNABB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:24 2ND AVE NE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5045
Mailing Address - Country:US
Mailing Address - Phone:828-323-8230
Mailing Address - Fax:828-323-8232
Practice Address - Street 1:352 2ND ST NW STE 102
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-4954
Practice Address - Country:US
Practice Address - Phone:828-323-8230
Practice Address - Fax:828-323-8232
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC32268207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8958028Medicaid
NC204203Medicare ID - Type Unspecified
NCB42684Medicare UPIN