Provider Demographics
NPI:1871511014
Name:MCGAULEY, DAVID P (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:MCGAULEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3400 OLD MILTON PKWY STE C585
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4434
Mailing Address - Country:US
Mailing Address - Phone:770-475-3200
Mailing Address - Fax:770-475-2228
Practice Address - Street 1:3400 OLD MILTON PKWY STE C585
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4434
Practice Address - Country:US
Practice Address - Phone:770-475-3200
Practice Address - Fax:770-475-2228
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA041164207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF66820Medicare UPIN
GA08BBWHKMedicare ID - Type Unspecified