Provider Demographics
NPI:1306829544
Name:MCCARTY, JAMES M (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:MCCARTY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:20905 12 MILE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066
Mailing Address - Country:US
Mailing Address - Phone:586-772-3500
Mailing Address - Fax:586-772-6540
Practice Address - Street 1:20905 E 12 MILE RD
Practice Address - Street 2:STE 100
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-6501
Practice Address - Country:US
Practice Address - Phone:586-772-3500
Practice Address - Fax:586-772-6540
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5901001464213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI485505289OtherBCBS
MI1306829544OtherRAILROAD MEDICARE
MI3017502Medicaid
MI1306829544OtherRAILROAD MEDICARE
U21969Medicare UPIN