Healthcare Provider Details

I. General information

NPI: 1932384831
Provider Name (Legal Business Name): DAVID MCGRATH MD INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1046 6TH AVE SW
ALBANY OR
97321-1916
US

IV. Provider business mailing address

PO BOX 4008
PORTLAND OR
97208-4008
US

V. Phone/Fax

Practice location:
  • Phone: 541-926-2244
  • Fax: 503-372-2754
Mailing address:
  • Phone: 503-372-2740
  • Fax: 503-372-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID MICHAEL MCGRATH
Title or Position: PRESIDENT
Credential: MD
Phone: 503-372-2740