Healthcare Provider Details

I. General information

NPI: 1487639704
Provider Name (Legal Business Name): DAVID SCOTT MCCALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3212 KUTZTOWN RD
LAURELDALE PA
19605-2661
US

IV. Provider business mailing address

3212 KUTZTOWN RD
LAURELDALE PA
19605-2661
US

V. Phone/Fax

Practice location:
  • Phone: 610-816-2060
  • Fax: 610-685-9290
Mailing address:
  • Phone: 610-816-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number205755
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD036626E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: