Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | OS5523 | FL |
NPI | 1194932244 |
---|---|
Provider Name | Dr. Douglas W David |
First Address | Hollywood, FL 33024-8063 |
Second Address | Fort Lauderdale, FL 33309-6348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E51676 | (02) |