Provider Demographics
NPI:1346239092
Name:MCBRIDE, DAVID R (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1701 JOHN F KENNEDY BLVD
Mailing Address - Street 2:COMCAST HEALTH CENTER, FLOOR 25
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-0001
Mailing Address - Country:US
Mailing Address - Phone:215-330-2029
Mailing Address - Fax:
Practice Address - Street 1:1701 JOHN F KENNEDY BLVD
Practice Address - Street 2:COMCAST HEALTH CENTER, FLOOR 25
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-0001
Practice Address - Country:US
Practice Address - Phone:215-330-2029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78214207Q00000X
NY304356207Q00000X
PAMD449226207Q00000X
CT72211207Q00000X
DEC1-0023924207Q00000X
NJ25MA10914500207Q00000X
FLME145278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110075174AMedicaid
MASX4974Medicare PIN