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Individual

GREGORY MCCABE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
269 S CANDY LN, COTTONWOOD, AZ 86326-4158
(928) 639-6159
(928) 639-5066
Mailing address
269 S CANDY LN, COTTONWOOD, AZ 86326-4158
(928) 639-6159
(928) 639-5066

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
28769
SC
207L00000X
Anesthesiology Physician
Primary
36617
AZ
207L00000X
Anesthesiology Physician
ME 102756
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
155031900
US DEPT OF LABOR
SC
01
192356
MEDCOST
SC
05
287692
SC
01
570835798
STANDARD TAX ID
SC
05
5905854
NC
Enumeration date
07/25/2006
Last updated
09/23/2008
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