Provider Demographics
NPI:1881612638
Name:MCCARTY, MARCIA SUSAN MILLER (MD)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:SUSAN MILLER
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:SUSAN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:278 PROSPECT CIR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:278 PROSPECT CIR
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1643
Practice Address - Country:US
Practice Address - Phone:717-227-1619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7720873OtherAETNA
PA100929824Medicaid
PA100458OtherGEISINGER
PA1428531OtherHIGHMARK BLUE SHIELD
PA2113754000OtherAMERIHEALTH 65 PA
PA107614OtherJOHNS HOPKINS
MD641973OtherCAREFIRST MD BCBS
PAP00223334Medicare PIN
PAI13050Medicare UPIN