Provider Demographics
NPI:1972554400
Name:HIGH, DAVID A (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:HIGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:622 STOKES RD
Mailing Address - Street 2:STE A
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2913
Mailing Address - Country:US
Mailing Address - Phone:609-953-0908
Mailing Address - Fax:609-953-5978
Practice Address - Street 1:622 STOKES RD
Practice Address - Street 2:STE A
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2913
Practice Address - Country:US
Practice Address - Phone:609-953-0908
Practice Address - Fax:609-953-5978
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04723800207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2377101Medicaid
NJ465312Medicare ID - Type Unspecified
F00015Medicare UPIN