Provider Demographics
NPI:1467545152
Name:MASSEY, DAVID QUINTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:QUINTIN
Last Name:MASSEY
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 1:2009 NORTH AUGUSTA STREET
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401
Mailing Address - Country:US
Mailing Address - Phone:540-885-0675
Mailing Address - Fax:540-885-6060
Practice Address - Street 1:2009 NORTH AUGUSTA STREET
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401
Practice Address - Country:US
Practice Address - Phone:540-885-0675
Practice Address - Fax:540-885-6060
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA278292OtherSOUTHERN HEALTH
VA063197OtherBCBS
VA005648301Medicaid
VA278292OtherSOUTHERN HEALTH
VA541530946OtherEIN
VA278292OtherSOUTHERN HEALTH