Healthcare Provider Details

I. General information

NPI: 1437111440
Provider Name (Legal Business Name): DAVID MARK MCGREW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4644 KEYSVILLE AVE
SPRING HILL FL
34608-3515
US

IV. Provider business mailing address

4644 KEYSVILLE AVE
SPRING HILL FL
34608-3515
US

V. Phone/Fax

Practice location:
  • Phone: 352-683-6847
  • Fax:
Mailing address:
  • Phone: 352-683-6847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number82687
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number59920
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME42526
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: