Provider Demographics
NPI:1356705883
Name:MACDONALD, BRIAN ALEXANDER JR (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ALEXANDER
Last Name:MACDONALD
Suffix:JR
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:2350 MAPLE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4080
Mailing Address - Country:US
Mailing Address - Phone:716-688-6500
Mailing Address - Fax:
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:DAVID K. MILLER BUILDING, INTERNAL MEDICINE RESIDENCY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY300600207RG0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program