Healthcare Provider Details

I. General information

NPI: 1952398943
Provider Name (Legal Business Name): DAVID E LAW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5517 21ST AVE W STE F
BRADENTON FL
34209-5604
US

IV. Provider business mailing address

5517 21ST AVE W STE F
BRADENTON FL
34209-5604
US

V. Phone/Fax

Practice location:
  • Phone: 941-792-8383
  • Fax: 941-792-8484
Mailing address:
  • Phone: 941-792-8383
  • Fax: 941-792-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME0039816
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME39816
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: