Provider Demographics
NPI:1508127069
Name:MCBRIDE, DARRELL ANDRE II (DO)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:ANDRE
Last Name:MCBRIDE
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-271-6408
Practice Address - Fax:570-271-5845
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2020-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS019229207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10350001110001Medicaid