Provider Demographics
NPI:1902002124
Name:MCDUFF, DAVID ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:MCDUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4618 BRENTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5958
Mailing Address - Country:US
Mailing Address - Phone:443-416-6368
Mailing Address - Fax:410-730-7487
Practice Address - Street 1:3454 ELLICOTT CENTER DR
Practice Address - Street 2:MARYLAND CENTERS FOR PSYCHIATRY-SUITE 106
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4113
Practice Address - Country:US
Practice Address - Phone:410-461-3760
Practice Address - Fax:410-461-0526
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00365222084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE27463Medicare UPIN