Provider Demographics
NPI:1730339029
Name:MCCARTHY, BRENDAN WILLIAM
Entity type:Individual
Prefix:MR
First Name:BRENDAN
Middle Name:WILLIAM
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 NIDER BLVDR STE 100
Mailing Address - Street 2:ADMIRAL JOEL T. BOONE BRANCH HEALTH CLINIC
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23459-2341
Mailing Address - Country:US
Mailing Address - Phone:757-953-8154
Mailing Address - Fax:
Practice Address - Street 1:1317 BALLAHACK RD
Practice Address - Street 2:STE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-2463
Practice Address - Country:US
Practice Address - Phone:757-953-6259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman