Provider Demographics
NPI:1467449801
Name:MCBRIDE, MARK S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1285 HEMBREE RD
Mailing Address - Street 2:SUITE 200-A
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5720
Mailing Address - Country:US
Mailing Address - Phone:770-475-2710
Mailing Address - Fax:770-360-0498
Practice Address - Street 1:1285 HEMBREE RD
Practice Address - Street 2:SUITE 200-A
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5720
Practice Address - Country:US
Practice Address - Phone:770-475-2710
Practice Address - Fax:770-360-0498
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2007-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA034406207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20BBDPSMedicare PIN
GAE86411Medicare UPIN