Provider Demographics
NPI:1578561080
Name:MCCARTY, MICHEAL ERIK (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHEAL
Middle Name:ERIK
Last Name:MCCARTY
Suffix:
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 1:11438 WOODS BAY LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9166
Mailing Address - Country:US
Mailing Address - Phone:317-826-9398
Mailing Address - Fax:317-826-9405
Practice Address - Street 1:720 N LINCOLN ST
Practice Address - Street 2:DCMH EMERGENCY DEPT.
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-1327
Practice Address - Country:US
Practice Address - Phone:812-663-1160
Practice Address - Fax:812-663-1140
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041803A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200023260Medicaid
IN940420KKKMedicare ID - Type Unspecified
IN200023260Medicaid
INM400074692Medicare PIN