Provider Demographics
NPI:1184688764
Name:MCCARTY, MARTHA E (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:E
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8602
Mailing Address - Country:US
Mailing Address - Phone:781-643-5407
Mailing Address - Fax:781-646-6151
Practice Address - Street 1:29 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8602
Practice Address - Country:US
Practice Address - Phone:781-643-4507
Practice Address - Fax:781-646-6151
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA70683208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3147878Medicaid
MAJ08812Medicare ID - Type Unspecified
MA3147878Medicaid