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Individual
MARY ELLEN MCINTIRE
Active
Individual
MARY ELLEN MCINTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47600
AZ
208D00000X
General Practice Physician
36832
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31273
TLC
TN
05
—
3891205
—
TN
05
—
863437
—
AZ
01
—
P00183551
RAILROAD MEDICARE
TN
Enumeration date
07/04/2006
Last updated
10/03/2015
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