Provider Demographics
NPI:1689734386
Name:MCDONALD, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2671B AVENIR PL
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-7176
Mailing Address - Country:US
Mailing Address - Phone:703-207-8600
Mailing Address - Fax:703-207-9224
Practice Address - Street 1:2671B AVENIR PL
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-7176
Practice Address - Country:US
Practice Address - Phone:703-849-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-034052207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1689734386OtherVA BOARD OF MEDICINE
VA541203544 22031 A001OtherTRICARE
VA0101034052OtherVA BOARD OF MEDICINE
VA541203544 0004OtherCIGNA
VA8083OtherCAREFIRST BLUECROSS BLUE