Provider Demographics
NPI:1265450019
Name:DEATON, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:DEATON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL CENTER DR STE 512
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1273
Practice Address - Country:US
Practice Address - Phone:413-794-5550
Practice Address - Fax:413-794-4212
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA72851208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA072851OtherTUFTS
MA0013230OtherNEIGHBORHOOD HEALTH PLAN
MAJ09596OtherBLUE CROSS OF MA
MA330001977OtherRAILROAD MEDICARE
MA000000023012OtherBMC-HEALTHNET
MA11714OtherHEALTH NEW ENGLAND
MA3061108Medicaid
MA26143OtherHARVARD PILGRIM
MAE65587Medicare UPIN
MA484135OtherCONNECTICARE
MAJ09596Medicare PIN