Provider Demographics
NPI:1285653568
Name:HUNGARLAND, JOHN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:HUNGARLAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4545 RIVERSIDE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-5172
Mailing Address - Country:US
Mailing Address - Phone:434-799-5800
Mailing Address - Fax:434-799-5801
Practice Address - Street 1:4545 RIVERSIDE DR
Practice Address - Street 2:SUITE A
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-5172
Practice Address - Country:US
Practice Address - Phone:434-799-5800
Practice Address - Fax:434-799-5801
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2008-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101224431207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X582P01Medicare PIN
G72139Medicare UPIN