Provider Demographics
NPI:1245262112
Name:MCAFEE, MOLLY (MD)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:MCAFEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MATTHEW ST STE 401
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1656
Mailing Address - Country:US
Mailing Address - Phone:740-374-2252
Mailing Address - Fax:740-374-4974
Practice Address - Street 1:400 MATTHEW ST STE 401
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1656
Practice Address - Country:US
Practice Address - Phone:740-374-2252
Practice Address - Fax:740-374-4974
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-114840208G00000X
OH35.132394208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036114840Medicaid
IL206147OtherMEDICARE PTAN (GROUP)
ILP01209473OtherMEDICARE RAILROAD (PROVIDER PTAN)
IL206147106OtherMEDICARE PTAN (INDIVIDUAL)
ILCA4748OtherMEDICARE RAILROAD (GROUP PTAN)
E59757Medicare UPIN