Provider Demographics
NPI:1609675354
Name:MCCABE, DOUGLAS P
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:P
Last Name:MCCABE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 GOUGLER RD
Mailing Address - Street 2:
Mailing Address - City:COVENTRY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44319-2518
Mailing Address - Country:US
Mailing Address - Phone:234-369-9422
Mailing Address - Fax:
Practice Address - Street 1:688 GOUGLER RD
Practice Address - Street 2:
Practice Address - City:COVENTRY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44319-2518
Practice Address - Country:US
Practice Address - Phone:234-369-9422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant