Provider Demographics
NPI:1801892351
Name:MCCAW, PATRICIA J (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:MCCAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:301 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748-1113
Practice Address - Country:US
Practice Address - Phone:563-285-7232
Practice Address - Fax:563-285-6742
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2021-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA33119207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
078284OtherHEALTH ALLIANCE
50311OtherIOWA HEALTH SOLUTIONS
IA0178OtherJOHN DEERE HEALTH PLAN
29015OtherWELLMARK BC/BS
4796890010OtherDMERC
IA4187062Medicaid
IAI5680Medicare PIN
IA4187062Medicaid