Provider Demographics
NPI:1689634115
Name:MCGINNIS, DAVID EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
Last Name:MCGINNIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:363 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3703
Practice Address - Country:US
Practice Address - Phone:508-973-7447
Practice Address - Fax:508-973-7424
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2020-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA231821207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA101081463Medicaid
I14629Medicare UPIN