Provider Demographics
NPI:1235295478
Name:REARICK, DAVID ALVIN (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALVIN
Last Name:REARICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4372 MOSS RIDGE CT NE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5227
Mailing Address - Country:US
Mailing Address - Phone:770-992-0059
Mailing Address - Fax:770-992-0912
Practice Address - Street 1:4372 MOSS RIDGE CT NE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5227
Practice Address - Country:US
Practice Address - Phone:770-992-0059
Practice Address - Fax:770-992-0912
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA019759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine