Provider Demographics
NPI:1427021872
Name:MCDONALD, JOHN Z (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:Z
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:Z
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:523 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6051
Mailing Address - Country:US
Mailing Address - Phone:215-355-7900
Mailing Address - Fax:215-355-9005
Practice Address - Street 1:523 BUSTLETON PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6051
Practice Address - Country:US
Practice Address - Phone:215-355-7900
Practice Address - Fax:215-355-9005
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004867L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009046530002Medicaid
428348XZYMedicare PIN
122367Medicare PIN
C33950Medicare UPIN