Provider Demographics
NPI:1356375950
Name:MCCARTHY, CAROL (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 US ROUTE 1
Mailing Address - Street 2:BUILDING C
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7609
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:887 CONGRESS ST
Practice Address - Street 2:SUITE 320
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3100
Practice Address - Country:US
Practice Address - Phone:207-662-5522
Practice Address - Fax:207-662-5527
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME013913208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30007595Medicaid
ME274810099Medicaid
MEMM5711Medicare PIN
NH30007595Medicaid
ME274810099Medicaid