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General NPI Number Information
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NPI Number | 1447795976
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Entity Type | Organization
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Legal Business Name | DAVID A HERF, MD
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 435 BROOKMEADE DR
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City | CRESTVIEW
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State | FL
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Zip | 32539-7304
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Country | US
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Telephone | 850-682-0409
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Fax | 850-689-1696
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Provider Business Mailing Address
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Address Line | 435 BROOKMEADE DR
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City | CRESTVIEW
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State | FL
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Zip | 32539-7304
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Country | US
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Telephone | 850-682-0409
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Fax | 850-689-1696
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Authorized Official
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Title or Position | OFFICE SUPERVISOR
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Name | PAMELA JOHNSON
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Credential |
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Telephone | 850-682-0409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME0043630
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License Number State | FL
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