Individual
MR. DAVID A. MCANULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6327 SE MILWAUKIE AVE, PORTLAND, OR 97202-5418
(503) 659-4988
(503) 353-1297
Mailing address
PO BOX 22075, MILWAUKIE, OR 97269-2075
(503) 659-4777
(503) 652-5223
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD17177
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028527
—
OR
01
—
080119173
RR MEDICARE
OR
Enumeration date
12/01/2005
Last updated
08/02/2010
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