Provider Demographics
NPI:1326264623
Name:DURHAM, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:DURHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NNMC
Mailing Address - Street 2:491 US HIGHWAY 64W
Mailing Address - City:SHIPROCK
Mailing Address - State:NM
Mailing Address - Zip Code:87420-1761
Mailing Address - Country:US
Mailing Address - Phone:505-368-7305
Mailing Address - Fax:505-368-7319
Practice Address - Street 1:NNMC
Practice Address - Street 2:491 US HIGHWAY 64W
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420-1761
Practice Address - Country:US
Practice Address - Phone:505-368-7305
Practice Address - Fax:505-368-7319
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2008-0595208D00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice