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Individual

DR. MICHAEL J MCCANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1117 S GEYER RD, SAINT LOUIS, MO 63122-7107
(314) 966-2723
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-6326

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36801
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10110
BLUE SHIELD
MO
01
1135162
UNITEDHEALTHCARE
05
203179510
MO
01
723655
HEALTHLINK
Enumeration date
09/02/2006
Last updated
12/03/2013
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