Provider Demographics
NPI:1467042697
Name:MCCARTY, GERALD WILLIAM II
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:WILLIAM
Last Name:MCCARTY
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 GOLFSIDE RD # 4
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1145
Mailing Address - Country:US
Mailing Address - Phone:810-343-8043
Mailing Address - Fax:
Practice Address - Street 1:2111 GOLFSIDE RD # 4
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1145
Practice Address - Country:US
Practice Address - Phone:810-343-8043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator