Provider Demographics
NPI:1700042694
Name:DAVID W NUSSEAR MD LLC
Entity Type:Organization
Organization Name:DAVID W NUSSEAR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:NUSSEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-426-8331
Mailing Address - Street 1:PO BOX 918982
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8982
Mailing Address - Country:US
Mailing Address - Phone:908-653-1283
Mailing Address - Fax:
Practice Address - Street 1:460 SAINT CHARLES CT
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2103
Practice Address - Country:US
Practice Address - Phone:407-585-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty