Provider Demographics
NPI:1457322281
Name:HULT, DAVID D (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:D
Last Name:HULT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2000 Q STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-3610
Mailing Address - Country:US
Mailing Address - Phone:402-421-0904
Mailing Address - Fax:402-421-0946
Practice Address - Street 1:3910 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4783
Practice Address - Country:US
Practice Address - Phone:402-434-7383
Practice Address - Fax:402-434-7382
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE16997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080179259OtherRAILROAD MEDICARE
NE32390OtherBC/BS
NE10026082500Medicaid
NE47069425800Medicaid
NE4210OtherBLUE CROSS BLUE SHIELD
NE4391OtherMIDLANDS CHOICE
NE10026082500Medicaid
NE4391OtherMIDLANDS CHOICE
NE47069425800Medicaid