Healthcare Provider Details

I. General information

NPI: 1871574566
Provider Name (Legal Business Name): DAVID M HUANTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 10TH ST
PERRY IA
50220-2221
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-465-3553
  • Fax: 515-465-4319
Mailing address:
  • Phone: 515-465-3553
  • Fax: 515-465-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35387
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35387
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: