Healthcare Provider Details

I. General information

NPI: 1508127069
Provider Name (Legal Business Name): DARRELL ANDRE MCBRIDE II D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

493 BLACKWELL RD STE 202
WARRENTON VA
20186-2689
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 540-359-8002
  • Fax:
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0102209904
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberOS019229
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: