Provider Demographics
NPI:1982994703
Name:MCINDOE, DARRELL WINFRED (MD)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:WINFRED
Last Name:MCINDOE
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 1:15510 FOXPAW TRAIL
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797
Mailing Address - Country:US
Mailing Address - Phone:410-442-0291
Mailing Address - Fax:410-489-7574
Practice Address - Street 1:15510 FOXPAW TRAIL
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:MD
Practice Address - Zip Code:21797
Practice Address - Country:US
Practice Address - Phone:410-442-0291
Practice Address - Fax:410-489-7574
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020450207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine