Healthcare Provider Details

I. General information

NPI: 1730124165
Provider Name (Legal Business Name): DAVID JOHN DEAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5423 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

IV. Provider business mailing address

5423 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

V. Phone/Fax

Practice location:
  • Phone: 352-600-3434
  • Fax: 352-600-3403
Mailing address:
  • Phone: 352-600-3434
  • Fax: 352-600-3403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME44664
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: