MEDICARE: DR. ANDREW DAVID MCDONALD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35072767	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5859537	OTHER	OH	AETNA
2	020040838	OTHER	OH	TRAVLERS RAILROAD
3	000000027728	OTHER	OH	ANTHEM
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588647580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW DAVID MCDONALD M.D.

Provider Business Mailing Address
First Line	:	915 W MICHIGAN ST
Second Line	:
City	:	SIDNEY
State	:	OH
Zip	:	45365-2491
Country	:	US
Telephone Number	:	937-492-2094
Fax Number	:	937-492-1768

Provider Business Practice Location Address
First Line	:	915 W MICHIGAN ST
Second Line	:
City	:	SIDNEY
State	:	OH
Zip	:	45365-2491
Country	:	US
Telephone Number	:	937-492-2094
Fax Number	:	937-492-1768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	12/29/2020

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Directions to “ DR. ANDREW DAVID MCDONALD M.D.” Practice Location

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