Provider Demographics
NPI:1558321976
Name:MACDONALD, DAVID CHARLES (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:MACDONALD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1412 SACHEM PL STE 204630
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2499
Mailing Address - Country:US
Mailing Address - Phone:434-817-2725
Mailing Address - Fax:434-973-8083
Practice Address - Street 1:OSTEOPATHIC PHYSICIANS OF CHARLOTTESVILLE
Practice Address - Street 2:630 PETER JEFFERSON PKWY, SUITE 170
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8605
Practice Address - Country:US
Practice Address - Phone:434-973-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201863207Q00000X, 207QA0401X
VAVA0102201863207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine