=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700828662
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN B. MCDAY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2006
-----------------------------------------------------
Last Update Date | 03/24/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2058 MATSONS CIR
-----------------------------------------------------
City | VILLANOVA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19085-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-343-2435
-----------------------------------------------------
Fax | 610-527-3164
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2058 MATSONS CIR
-----------------------------------------------------
City | VILLANOVA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19085-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-343-2435
-----------------------------------------------------
Fax | 610-527-3164
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0001X
-----------------------------------------------------
Taxonomy Name | Radiation Oncology Physician
-----------------------------------------------------
License Number | MD019519E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2085R0001X
-----------------------------------------------------
Taxonomy Name | Radiation Oncology Physician
-----------------------------------------------------
License Number | 0101245559
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2085R0203X
-----------------------------------------------------
Taxonomy Name | Therapeutic Radiology Physician
-----------------------------------------------------
License Number | 042-0006520
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------