Individual
MR. MARK A MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21 HIGHLAND AVE SE, STE 100, ROANOKE, VA 24013-2218
(540) 344-9213
(540) 345-7559
Mailing address
21 HIGHLAND AVE SE, STE 100, ROANOKE, VA 24013-2218
(540) 344-9213
(540) 345-7559
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101051297
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006714153
—
VA
01
—
080286000
SOUTHERN HEALTH
VA
01
—
236880
MAMSI
VA
01
—
281060
ANTHEM
VA
01
—
4509836
AETNA
VA
01
—
5058981001
CIGNA
VA
01
—
54088505610
JOHN DEERE
VA
Enumeration date
06/09/2005
Last updated
11/17/2020
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