Provider Demographics
NPI:1780823393
Name:MCCARTY, DENISE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 103
Mailing Address - Street 2:BOX 2291
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09603-0023
Mailing Address - Country:US
Mailing Address - Phone:003-904-3430
Mailing Address - Fax:
Practice Address - Street 1:UNIT 6180
Practice Address - Street 2:BOX 245
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09604
Practice Address - Country:US
Practice Address - Phone:0039043-430-5692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1051646363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical