Provider Demographics
NPI:1609914431
Name:SARNOW, DAVID A (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:SARNOW
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 DIAMONDHEAD DR
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-3023
Mailing Address - Country:US
Mailing Address - Phone:512-791-3619
Mailing Address - Fax:
Practice Address - Street 1:208 W CASABLANCA AVE
Practice Address - Street 2:27 SOMDG/FLIGHT MEDICINE, BLDG 1400
Practice Address - City:CANNON AFB
Practice Address - State:NM
Practice Address - Zip Code:88103-5014
Practice Address - Country:US
Practice Address - Phone:575-784-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0431222083A0100X
GA431222083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine