Individual
TIMOTHY MATTHEW NEIL MCCABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 ALTURAS DR STE 101, MOSCOW, ID 83843-3263
(208) 310-7773
Mailing address
607 W MAIN ST, GRANGEVILLE, ID 83530-1345
(208) 983-1700
(208) 983-4665
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-15471
ID
Other
Enumeration date
11/06/2020
Last updated
02/08/2021
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