Provider Demographics
NPI:1487665261
Name:HALSEY, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:HALSEY
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:PO BOX 9000
Mailing Address - Street 2:
Mailing Address - City:EDGARTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02539-9000
Mailing Address - Country:US
Mailing Address - Phone:774-563-2981
Mailing Address - Fax:
Practice Address - Street 1:61 CURTIS LANE
Practice Address - Street 2:
Practice Address - City:EDGARTOWN
Practice Address - State:MA
Practice Address - Zip Code:02539
Practice Address - Country:US
Practice Address - Phone:774-563-2981
Practice Address - Fax:802-847-8996
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA268803207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0107529Y0NH0OtherBLUECROSS-ANTHEM
VT5382OtherBLUECROSS
NH30004156Medicaid
VT0009323Medicaid
5281OtherCIGNA
18P500OtherMVP
VTE35802Medicare UPIN
VT5382OtherBLUECROSS
VT0009323Medicaid