Provider Demographics
NPI:1598773848
Name:NESCHIS, DAVID G (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:NESCHIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-6902
Mailing Address - Country:US
Mailing Address - Phone:410-787-4594
Mailing Address - Fax:410-787-4846
Practice Address - Street 1:301 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5803
Practice Address - Country:US
Practice Address - Phone:410-553-8300
Practice Address - Fax:410-553-8349
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD56230208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD382251OtherMDIPA
MD214354OtherKAISER
MD0045OtherCAREFIRST REGIONAL
MD021502300Medicaid
MD2000430OtherUNITED HLTHCARE NATIONAL
MD3700166OtherUNITED HLTHCARE
DC033922201Medicaid
MD60648802OtherBLUE SHIELD
DE1000001313Medicaid
PA1900407/01Medicaid
MD80043OtherGEISINGER
MD80043OtherGEISINGER
DC033922201Medicaid
MD021502300Medicaid