Provider Demographics
NPI:1356510028
Name:MCCARTHY, BRENDAN MICHAEL (NMD)
Entity Type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:MICHAEL
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 S JENTILLY LN
Mailing Address - Street 2:SUITE C-4
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-5758
Mailing Address - Country:US
Mailing Address - Phone:480-557-9095
Mailing Address - Fax:
Practice Address - Street 1:1801 S JENTILLY LN
Practice Address - Street 2:SUITE C-4
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-5758
Practice Address - Country:US
Practice Address - Phone:480-557-9095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0343171100000X
AZ08-1042175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist