Healthcare Provider Details

I. General information

NPI: 1487665261
Provider Name (Legal Business Name): DAVID A HALSEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 04/02/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 CURTIS LANE
EDGARTOWN MA
02539
US

IV. Provider business mailing address

PO BOX 9000
EDGARTOWN MA
02539-9000
US

V. Phone/Fax

Practice location:
  • Phone: 774-563-2981
  • Fax: 802-847-8996
Mailing address:
  • Phone: 774-563-2981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number268803
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: