Provider Demographics
NPI:1396238176
Name:MCCAULEY, MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MCCAULEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19 FRIENDSHIP ST STE 150-160
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2272
Mailing Address - Country:US
Mailing Address - Phone:401-845-3800
Mailing Address - Fax:401-845-1075
Practice Address - Street 1:19 FRIENDSHIP ST STE 150-160
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2272
Practice Address - Country:US
Practice Address - Phone:401-845-3800
Practice Address - Fax:401-845-1075
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT737642084N0400X
RIMD187192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology