Provider Demographics
NPI:1699911370
Name:MCBRIDE, MAURICE L (IDC)
Entity type:Individual
Prefix:MR
First Name:MAURICE
Middle Name:L
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3536 MCWHORTER CT UNIT A
Mailing Address - Street 2:
Mailing Address - City:FORT MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755-1286
Mailing Address - Country:US
Mailing Address - Phone:760-805-3922
Mailing Address - Fax:301-295-0847
Practice Address - Street 1:NATIONAL NAVAL MEDICAL CENTER BETHESDA
Practice Address - Street 2:MEDICAL SERVICES DIRECTORATE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4076
Practice Address - Fax:301-295-0847
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman