Provider Demographics
NPI:1275674236
Name:MCCARTER, THOMAS GERALD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GERALD
Last Name:MCCARTER
Suffix:JR
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 1:515 POLO RUN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-7100
Mailing Address - Country:US
Mailing Address - Phone:610-524-1225
Mailing Address - Fax:
Practice Address - Street 1:515 POLO RUN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-7100
Practice Address - Country:US
Practice Address - Phone:610-524-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054370L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01522912Medicaid
PA01522912Medicaid
47588Medicare ID - Type Unspecified