Provider Demographics
NPI:1598781478
Name:BUCHALTER, DAVID NEAL (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:NEAL
Last Name:BUCHALTER
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 1:4800 LINTON BLVD
Mailing Address - Street 2:BUILDING A, SUITE 201
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445
Mailing Address - Country:US
Mailing Address - Phone:561-496-6622
Mailing Address - Fax:561-865-1720
Practice Address - Street 1:4800 LINTON BLVD
Practice Address - Street 2:BUILDING A, SUITE 201
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6584
Practice Address - Country:US
Practice Address - Phone:561-496-6622
Practice Address - Fax:561-865-1720
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56979174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11760OtherBC/BS
FL0500073OtherGHI
FL0500073OtherGHI
11760ZMedicare ID - Type Unspecified