Provider Demographics
NPI:1760477327
Name:MCCARTHY, ROBERT EMMETT III (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EMMETT
Last Name:MCCARTHY
Suffix:III
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 1:10700 CHARTER DR
Mailing Address - Street 2:STE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3629
Mailing Address - Country:US
Mailing Address - Phone:410-715-0108
Mailing Address - Fax:410-995-3681
Practice Address - Street 1:10700 CHARTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3629
Practice Address - Country:US
Practice Address - Phone:410-715-0108
Practice Address - Fax:410-995-3681
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0046300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD520001600Medicaid
986L601EMedicare ID - Type Unspecified
MD520001600Medicaid