Provider Demographics
NPI:1285702704
Name:MCCOY, MALINDA M (MD)
Entity type:Individual
Prefix:DR
First Name:MALINDA
Middle Name:M
Last Name:MCCOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 NORTHCREEK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2377
Mailing Address - Country:US
Mailing Address - Phone:513-246-7000
Mailing Address - Fax:513-246-5284
Practice Address - Street 1:8240 NORTHCREEK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2377
Practice Address - Country:US
Practice Address - Phone:513-246-7000
Practice Address - Fax:513-246-5284
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG183800207Q00000X
OH35-05-7266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0892824Medicaid
OH0892824Medicaid
OH4197086Medicare PIN