Provider Demographics
NPI:1740258532
Name:WESTFALL, DAVID N (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:WESTFALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1290 ATHENS ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507-7000
Mailing Address - Country:US
Mailing Address - Phone:770-531-5641
Mailing Address - Fax:770-531-6035
Practice Address - Street 1:1290 ATHENS ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-7000
Practice Address - Country:US
Practice Address - Phone:770-531-5641
Practice Address - Fax:770-531-6035
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA015524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00180177DMedicaid
GA08BBWBCMedicare PIN
GAD31310Medicare UPIN
GA08CBCHKMedicare PIN