Provider Demographics
NPI:1609851930
Name:SIMPSON, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SIMPSON
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 30170
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-7170
Mailing Address - Country:US
Mailing Address - Phone:302-477-3300
Mailing Address - Fax:302-477-3168
Practice Address - Street 1:1401 FOULK RD
Practice Address - Street 2:SUITE 100B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2763
Practice Address - Country:US
Practice Address - Phone:302-477-3300
Practice Address - Fax:302-477-3168
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10004561207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG20232Medicare UPIN
DE003663C26Medicare PIN
DE823043F29Medicare PIN