Healthcare Provider Details

I. General information

NPI: 1235301052
Provider Name (Legal Business Name): DAVID FRANCIS MCPEAK M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 EDGERIDGE DR
PITTSBURGH PA
15234-2411
US

IV. Provider business mailing address

523 EDGERIDGE DR
PITTSBURGH PA
15234-2411
US

V. Phone/Fax

Practice location:
  • Phone: 412-563-0591
  • Fax: 412-920-1769
Mailing address:
  • Phone: 412-563-0591
  • Fax: 412-920-1769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS005664L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: