Provider Demographics
NPI:1013280130
Name:DURAND, DAVID BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRADLEY
Last Name:DURAND
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 1:5445 MATTHEW CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-6355
Mailing Address - Country:US
Mailing Address - Phone:941-554-4064
Mailing Address - Fax:941-554-4064
Practice Address - Street 1:5445 MATTHEW CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6355
Practice Address - Country:US
Practice Address - Phone:941-554-4064
Practice Address - Fax:941-554-4064
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 100793207ZC0500X, 207ZP0101X, 207ZP0102X
NY198886-1207ZC0500X, 207ZP0101X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01205898Medicaid