Provider Demographics
NPI:1326282427
Name:MACIAS, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:MACIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 715868
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19171-5868
Mailing Address - Country:US
Mailing Address - Phone:804-215-3063
Mailing Address - Fax:804-968-1803
Practice Address - Street 1:1920 BALLENGER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-6818
Practice Address - Country:US
Practice Address - Phone:703-810-5209
Practice Address - Fax:703-810-5414
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM-12514207X00000X
MS23990207X00000X
VA0101273343207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery