Provider Demographics
NPI:1851302590
Name:MCCARTHY, KEVIN EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:EDWARD
Last Name:MCCARTHY
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 1:825 WASHINGTON ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3441
Mailing Address - Country:US
Mailing Address - Phone:781-769-0500
Mailing Address - Fax:781-769-2267
Practice Address - Street 1:148 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2505
Practice Address - Country:US
Practice Address - Phone:781-453-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME015450208600000X
MA216306208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ26207OtherBLUE SHIELD
MA000000026867OtherBOSTON MEDICAL
MA802628OtherPILGRIM
MA216306OtherTUFTS INS.
MA0035302OtherNHP
MA703070OtherCIGNA
MAP201453844OtherONE HEALTH PLAN
MA2016460Medicaid
MA3226021OtherAETNA
MA50340OtherHEALTHYSTART
MA703070OtherCIGNA
MA000000026867OtherBOSTON MEDICAL
MAH85235Medicare UPIN