Provider Demographics
NPI:1033177258
Name:MCKAY, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:MCKAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-1838
Mailing Address - Country:US
Mailing Address - Phone:413-789-6800
Mailing Address - Fax:413-789-8098
Practice Address - Street 1:230 MAIN ST
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-1838
Practice Address - Country:US
Practice Address - Phone:413-789-6800
Practice Address - Fax:413-789-8098
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60558207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00022020OtherRAILROAD MEDICARE
MA3049272Medicaid
MA3049272Medicaid
MAE36855Medicare UPIN