Provider Demographics
NPI:1548238108
Name:BYBEE, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:BYBEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 22955
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4480
Mailing Address - Country:US
Mailing Address - Phone:209-571-0288
Mailing Address - Fax:209-338-6156
Practice Address - Street 1:4016 DALE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9268
Practice Address - Country:US
Practice Address - Phone:209-571-0288
Practice Address - Fax:209-571-0327
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG69334174400000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG69334OtherMEDICAL LICENSE
CA10944113OtherCAQH
CACA270459OtherMEDICARE
CABB1862324OtherDEA