Provider Demographics
NPI:1922052257
Name:HARVEY, DAVID MERIWETHER (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MERIWETHER
Last Name:HARVEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4400 MARSH LANDING BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-7215
Mailing Address - Country:US
Mailing Address - Phone:904-280-1221
Mailing Address - Fax:425-962-0007
Practice Address - Street 1:4400 MARSH LANDING BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-7215
Practice Address - Country:US
Practice Address - Phone:904-280-1221
Practice Address - Fax:425-962-0007
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 3912103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75994ZOtherMEDICARE PTAN
FL593622637OtherFEDERAL TAX ID