Provider Demographics
NPI:1437142098
Name:MCCAGH AND HERRING MD PA
Entity Type:Organization
Organization Name:MCCAGH AND HERRING MD PA
Other - Org Name:WESTERN MARYLAND DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-777-7900
Mailing Address - Street 1:100 WELTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1336
Mailing Address - Country:US
Mailing Address - Phone:301-777-7900
Mailing Address - Fax:301-777-5381
Practice Address - Street 1:100 WELTON DRIVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1336
Practice Address - Country:US
Practice Address - Phone:301-777-7900
Practice Address - Fax:301-777-5381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-29
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
103LMedicare ID - Type Unspecified