Healthcare Provider Details

I. General information

NPI: 1922052257
Provider Name (Legal Business Name): DAVID MERIWETHER HARVEY PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 MARSH LANDING BLVD SUITE 6
PONTE VEDRA BEACH FL
32082-7215
US

IV. Provider business mailing address

4400 MARSH LANDING BLVD SUITE 6
PONTE VEDRA BEACH FL
32082-7215
US

V. Phone/Fax

Practice location:
  • Phone: 904-280-1221
  • Fax: 425-962-0007
Mailing address:
  • Phone: 904-280-1221
  • Fax: 425-962-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY 3912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: