Provider Demographics
NPI:1790766079
Name:SANMIGUEL, DAVID ESPINOLA (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ESPINOLA
Last Name:SANMIGUEL
Suffix:
Gender:M
Credentials:DO
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 4087
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-0087
Mailing Address - Country:US
Mailing Address - Phone:423-710-5233
Mailing Address - Fax:
Practice Address - Street 1:2341 MCCALLIE AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3239
Practice Address - Country:US
Practice Address - Phone:423-698-3309
Practice Address - Fax:423-698-3309
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA84546207L00000X
TND01446207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G04244Medicare UPIN
TN3306694Medicare UPIN