Provider Demographics
NPI:1548411978
Name:DAVID M LASHWAY MD PA
Entity Type:Organization
Organization Name:DAVID M LASHWAY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:LASHWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-738-9761
Mailing Address - Street 1:2623 S SEACREST BLVD
Mailing Address - Street 2:STE 112
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7501
Mailing Address - Country:US
Mailing Address - Phone:561-738-9761
Mailing Address - Fax:561-738-5592
Practice Address - Street 1:2623 S SEACREST BLVD
Practice Address - Street 2:STE 112
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7501
Practice Address - Country:US
Practice Address - Phone:561-738-9761
Practice Address - Fax:561-738-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046984207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063630400Medicaid
FL05793Medicare PIN
FLD51421Medicare UPIN