Provider Demographics
NPI:1952398943
Name:LAW, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:LAW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5517 21ST AVE W
Mailing Address - Street 2:STE F
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5604
Mailing Address - Country:US
Mailing Address - Phone:941-792-8383
Mailing Address - Fax:941-792-8484
Practice Address - Street 1:5517 21ST AVE W
Practice Address - Street 2:STE F
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5604
Practice Address - Country:US
Practice Address - Phone:941-792-8383
Practice Address - Fax:941-792-8484
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2012-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0039816207RP1001X
FLME39816207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC75984Medicare UPIN