Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatric Allergy/Immunology |
2080P0201X | 37 | Physician/Pediatric Medicine |
| NPI # | 1598983827 |
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| LBN Legal business name | MICHAEL MCCUBBIN, MD, PC | ||||||||||||||||
| Authorized official | MICHAEL MCCUBBIN - (PHYSICIAN/OWNER) | ||||||||||||||||
| Entity | Organization | ||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||
| Enumeration date | 04/23/2007 | ||||||||||||||||
| Last updated | 11/10/2010 - About 16 years ago | ||||||||||||||||
| Identifiers |
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