Provider Demographics
NPI:1831138155
Name:PARMER, DAVID V (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:V
Last Name:PARMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 13TH AVE SE, SUITE D
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-355-1843
Mailing Address - Fax:256-340-2553
Practice Address - Street 1:1304 13TH AVE SE, SUITE D
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601
Practice Address - Country:US
Practice Address - Phone:256-355-1843
Practice Address - Fax:256-340-2553
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19503208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
01-0755845OtherTAX IDENTIFICATION NUMBER
AL009918345Medicaid
AL51514907PAROtherBCBS PROVIDER #
ALG22553Medicare UPIN