Provider Demographics
NPI:1629068077
Name:GOULD, DAVID W III (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:W
Last Name:GOULD
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1000 BOULDERS PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225
Mailing Address - Country:US
Mailing Address - Phone:804-320-7881
Mailing Address - Fax:804-560-3474
Practice Address - Street 1:1000 BOULDERS PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225
Practice Address - Country:US
Practice Address - Phone:804-320-7881
Practice Address - Fax:804-560-3474
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2015-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010452352084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007135017Medicaid
VA260000977Medicare PIN
VAE86048Medicare UPIN