Provider Demographics
NPI:1932105533
Name:MCCARNEY, MICHAEL T (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:T
Last Name:MCCARNEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 STERLING CIR
Mailing Address - Street 2:
Mailing Address - City:UNION HALL
Mailing Address - State:VA
Mailing Address - Zip Code:24176-4010
Mailing Address - Country:US
Mailing Address - Phone:804-608-3040
Mailing Address - Fax:804-598-9197
Practice Address - Street 1:6003 HARBOUR PARK DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2160
Practice Address - Country:US
Practice Address - Phone:804-745-7822
Practice Address - Fax:804-745-7804
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU62173Medicare UPIN
VA003826C60Medicare ID - Type UnspecifiedMEDICARE