Provider Demographics
NPI:1518960483
Name:EGGERS, DAVID M (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:EGGERS
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 1642
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-0043
Mailing Address - Country:US
Mailing Address - Phone:812-758-4199
Mailing Address - Fax:812-471-6650
Practice Address - Street 1:4133 GATEWAY BLVD STE 170
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8950
Practice Address - Country:US
Practice Address - Phone:812-758-4199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01033359A174400000X, 207T00000X
KY19590174400000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100007810AMedicaid
KY64195902Medicaid
IN100007810AMedicaid
KY110087166/DA1728Medicare PIN
000000388443OtherANTHEM
IN100007810AMedicaid
KY649901Medicare PIN
IN202280IMedicare PIN