Provider Demographics
NPI:1881661924
Name:DONAGHY, DEIRDRE V (MD)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:V
Last Name:DONAGHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEIRDRE
Other - Middle Name:V
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:104 PHEASANT RUN
Mailing Address - Street 2:SUITE 128
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3439
Mailing Address - Country:US
Mailing Address - Phone:215-860-3344
Mailing Address - Fax:215-860-8950
Practice Address - Street 1:104 PHEASANT RUN
Practice Address - Street 2:STE. 140
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3439
Practice Address - Country:US
Practice Address - Phone:215-860-3344
Practice Address - Fax:215-860-8950
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044534E207RC0000X
NJ25MA06774000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014410550001Medicaid
PA1030775OtherKEYSTONE MERCY
PA688590OtherPENNSYLVANIA BLUE SHIELD
PA0523252000OtherKEYSTONE
PA060045615OtherRAILROAD MEDICARE
PA0014410550001Medicaid
PA688590OtherPENNSYLVANIA BLUE SHIELD
PA688590D00Medicare PIN
PA0523252000OtherKEYSTONE
PAE99474Medicare UPIN