Provider Demographics
NPI:1164580049
Name:MCBRIDE, DAVID LAWRENCE (MS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LAWRENCE
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7353 E SAYAN ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-1821
Mailing Address - Country:US
Mailing Address - Phone:480-218-4280
Mailing Address - Fax:
Practice Address - Street 1:6550 E BROADWAY RD
Practice Address - Street 2:SUITE 206
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1732
Practice Address - Country:US
Practice Address - Phone:480-981-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA825237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ27693Medicare ID - Type Unspecified