Provider Demographics
NPI:1407826795
Name:MCBRIDE, MICHAEL DORIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DORIAN
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BRIGHT PEDIATRICS
Mailing Address - Street 2:2366 BATTLEFIELD PKWY
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742
Mailing Address - Country:US
Mailing Address - Phone:705-841-0150
Mailing Address - Fax:705-841-0151
Practice Address - Street 1:BRIGHT PEDIATRICS
Practice Address - Street 2:2366 BATTLEFIELD PKWY
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742
Practice Address - Country:US
Practice Address - Phone:705-841-0150
Practice Address - Fax:705-841-0151
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA71447208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64226426Medicaid
KY64226426Medicaid