Provider Demographics
NPI:1114773181
Name:MCCARTHY, MIA F (PA-C)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:F
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17388 N VILLAGE MAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-7240
Mailing Address - Country:US
Mailing Address - Phone:302-291-6050
Mailing Address - Fax:
Practice Address - Street 1:17388 N VILLAGE MAIN BLVD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-7240
Practice Address - Country:US
Practice Address - Phone:302-291-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant