Provider Demographics
NPI:1730124165
Name:DEAM, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:DEAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5423 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1110
Mailing Address - Country:US
Mailing Address - Phone:352-600-3434
Mailing Address - Fax:352-600-3403
Practice Address - Street 1:5423 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1110
Practice Address - Country:US
Practice Address - Phone:352-600-3434
Practice Address - Fax:352-600-3403
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44664208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME44664OtherSTATE LICENSE
FLME44664OtherSTATE LICENSE
FLD63222Medicare UPIN
FL94362ZMedicare PIN