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Individual

DAVID M MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
397 WALLACE RD, SUITE C-314, NASHVILLE, TN 37211-4854
(615) 846-1625
(615) 846-1630
Mailing address
PO BOX 501123, SAINT LOUIS, MO 63150-0001
(615) 846-1625
(615) 846-1630

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20623
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30524821
TN
01
4171503
BLUE CROSS BLUE SHIELD
TN
01
4224456
AETNA
TN
Enumeration date
03/20/2006
Last updated
05/06/2008
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