Provider Demographics
NPI:1689614042
Name:MCHARG, MALCOLM (MD)
Entity Type:Individual
Prefix:
First Name:MALCOLM
Middle Name:
Last Name:MCHARG
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 1:721 ARBOR WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1917
Mailing Address - Country:US
Mailing Address - Phone:610-279-7443
Mailing Address - Fax:610-279-3784
Practice Address - Street 1:721 ARBOR WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1917
Practice Address - Country:US
Practice Address - Phone:610-279-7443
Practice Address - Fax:610-279-3784
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044607L2084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E84151Medicare UPIN
PA669783Medicare PIN