Provider Demographics
NPI:1598723660
Name:MCCABE, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:MCCABE
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:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-277-2000
Mailing Address - Fax:336-277-2050
Practice Address - Street 1:186 KIMEL PARK DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6946
Practice Address - Country:US
Practice Address - Phone:336-277-2000
Practice Address - Fax:336-277-2050
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901253207RC0000X, 207U00000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC216692OtherMAMSI
NC8912391Medicaid
NC4939934001OtherCIGNA
NC91740OtherMEDCOST
NC7467098OtherAETNA
NC2508100OtherUNITED HEALTH CARE
NC12391OtherBCNC
NCP00654532OtherRAILROAD MEDICARE
NC2279772AOtherFMC PROVIDER NUMBER
NC060054187OtherRAILROAD MEDICARE
NC2279772BOtherMPH PROVIDER NUMBER
NC34971OtherPARTNERS MEDICARE
NC2279772Medicare PIN
NC060054187OtherRAILROAD MEDICARE
NC7467098OtherAETNA