Individual
MACDARA GERARD TYNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200600478
NC
208M00000X
Hospitalist Physician
200600478
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142KK
BCBS
NC
05
—
5903367
—
NC
05
—
N78008
—
SC
Enumeration date
10/13/2005
Last updated
02/25/2025
Update your record
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