# ROBERT L MCQUADY JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1962588574
- **Gender:** Man
- **Credential:** M.D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 15528 | KY | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 01079670A | IN | — |
| 207V00000X | Obstetrics & Gynecology Physician | 01079670A | IN | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 11/08/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01079670A | STATE LICENSE | IN |
| 05 | — | 300010808 | — | IN |
| 01 | — | IN3604023 | MEDICARE PTAN | IN |
| 01 | — | K177821 | MEDICARE KY | KY |