Provider Demographics
NPI:1265515043
Name:MULCAHY, JOSEPH W (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:MULCAHY
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 1:1211 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2562
Mailing Address - Country:US
Mailing Address - Phone:360-299-4945
Mailing Address - Fax:360-299-4269
Practice Address - Street 1:1213 24TH ST STE 700
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2595
Practice Address - Country:US
Practice Address - Phone:360-293-5142
Practice Address - Fax:360-299-2043
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300547174400000X
WAMD60066486208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8014CAMedicaid
WA2002703Medicaid
NC8014CAMedicaid