Provider Demographics
NPI:1386613057
Name:MCANULTY, JAMES G (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:MCANULTY
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 1:3 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2362
Mailing Address - Country:US
Mailing Address - Phone:410-228-3223
Mailing Address - Fax:410-901-8195
Practice Address - Street 1:3 CEDAR ST
Practice Address - Street 2:DORCHESTER COUNTY HEALTH DEPARTMENT
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2362
Practice Address - Country:US
Practice Address - Phone:410-228-3223
Practice Address - Fax:410-901-8195
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0046434208600000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7089349OtherMAMSI
MDP00100834OtherPALMETTO GBA - RAILROAD
MD005FMedicare PIN
MD7089349OtherMAMSI
MDB85880Medicare UPIN
MDVA05I256Medicare PIN