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General NPI Number Information
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NPI Number | 1891708160
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Entity Type | Individual
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Provider Name | DR. DAVID L DEAVER
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3210 CHURCHLAND BLVD SUITE 4
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5253
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Country | US
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Telephone | 757-483-3340
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Fax | 757-483-0461
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Provider Business Mailing Address
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Address Line | 234 N BLAKE RD
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City | NORFOLK
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State | VA
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Zip | 23505-4404
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Country | US
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Telephone | 757-423-6331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810000797
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License Number State | VA
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