Provider Demographics
NPI:1942252796
Name:CACCESE, DAVID M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:CACCESE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:401 N 17TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5034
Practice Address - Country:US
Practice Address - Phone:610-432-1427
Practice Address - Fax:610-774-9741
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2011-01-06
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Provider Licenses
StateLicense IDTaxonomies
PAMD012740E207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110090755OtherPALMETTO RR
PA149115OtherHIGHMARK PA BLUE SHIELD
PA01056501OtherCAPITAL BLUE CROSS
PAB39862Medicare UPIN
PA149115H9MMedicare PIN
PA01056501OtherCAPITAL BLUE CROSS