Healthcare Provider Details

I. General information

NPI: 1841251063
Provider Name (Legal Business Name): DAVID S HURST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 SPRING STREET SUITE D
SCARBOROUGH ME
04074
US

IV. Provider business mailing address

23 SPRING STREET SUITE D
SCARBOROUGH ME
04074
US

V. Phone/Fax

Practice location:
  • Phone: 207-883-6464
  • Fax: 207-883-6556
Mailing address:
  • Phone: 207-883-6464
  • Fax: 207-883-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number008035
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: