Basic Information
| Provider Information | |||||||||
| NPI: | 1609988039 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOUD | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | SUITE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7173341885 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 S WASHINGTON ST | ||||||||
| Address2: | 3RD FLOOR SUITE C | ||||||||
| City: | GETTYSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173252500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173393110 | ||||||||
| FaxNumber: | 7173341885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 06/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | OS009010L | PA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207P00000X | OS009010L | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 208600000X | OS009010L | PA | Y | Allopathic & Osteopathic Physicians | Surgery | 2086S0120X | OS009010L | PA | N | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | 2086S0129X | OS009010L | PA | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 208C00000X | OS009010L | PA | N | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | 208G00000X | OS009010L | PA | N | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
ID Information
| ID | Type | State | Issuer | Description | 50075818 | 01 | PA | CAPITAL BLUE CROSS WMG | OTHER | 007548540 | 05 | PA | MEDICAID | 232732 | 01 | PA | UNISON WMG | OTHER | 7483010 | 01 | PA | AETNA | OTHER | 105655 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 595396 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 1521272 | 01 | PA | GATEWAY-WMG | OTHER | 20072212 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 216753 | 01 | PA | JOHNS HOPKINS | OTHER |