Provider Demographics
NPI:1982812012
Name:YOUNG, DAVID EDMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDMOND
Last Name:YOUNG
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:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:484-628-0797
Mailing Address - Fax:484-334-7026
Practice Address - Street 1:7173 BERNVILLE RD
Practice Address - Street 2:
Practice Address - City:BERNVILLE
Practice Address - State:PA
Practice Address - Zip Code:19506-8624
Practice Address - Country:US
Practice Address - Phone:610-816-2040
Practice Address - Fax:610-488-0534
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4344412083P0011X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022052330002Medicaid
PAP00662919Medicare PIN
PA823546OtherFIRST PRIORITY HEALTH (SPECIALIST)
PA2062157OtherHIGHMARK BLUE SHIELD
PA1022052330002Medicaid
PAP00662919Medicare PIN