Provider Demographics
NPI:1851497242
Name:DAVID, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:DAVID
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Gender:M
Credentials:MD
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Mailing Address - Street 1:910 WILLISTON PARK PT
Mailing Address - Street 2:STE 1000
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2172
Mailing Address - Country:US
Mailing Address - Phone:407-833-8028
Mailing Address - Fax:407-833-8033
Practice Address - Street 1:910 WILLISTON PARK PT
Practice Address - Street 2:STE 1000
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2172
Practice Address - Country:US
Practice Address - Phone:407-833-8028
Practice Address - Fax:407-833-8033
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLME61238207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14653OtherBLUE SHIELD OF FLORIDA
FLD92263Medicare UPIN
FL14653Medicare ID - Type Unspecified