Provider Demographics
NPI:1386641801
Name:FALKENSTEIN, DAVID S
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:S
Last Name:FALKENSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 PADDINGTON CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-8724
Mailing Address - Country:US
Mailing Address - Phone:757-482-0547
Mailing Address - Fax:
Practice Address - Street 1:1035 NIDER BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23521-2701
Practice Address - Country:US
Practice Address - Phone:757-314-7429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840767363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical