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Individual

DR. DAVID S MEZEBISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
75 THOMAS JOHNSON DR STE H, FREDERICK, MD 21702-4895
(301) 668-9850
(301) 668-9853
Mailing address
75 THOMAS JOHNSON DR STE H, FREDERICK, MD 21702-4895
(301) 668-9850
(301) 668-9853

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
0101232840
VA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
D0043824
MD
207ND0900X
Dermatopathology Physician
0101232840
VA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
0101232840
VA
207NS0135X
Procedural Dermatology Physician
0101232840
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001
BLUE CROSS BLUE SHIELD FEDERAL
MD
01
001734127
MTST BCBS
WV
05
010165156
VA
01
180145
ANTHEM BLUE CROSS BLUE SHIELD OF VIRGINIA
VA
05
3810002827
WV
01
61854810
CAREFIRST BLUE CROSS BLUE SHIELD
MD
01
P00252754
RR MEDICARE
VA
Enumeration date
01/28/2006
Last updated
01/25/2023
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