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1003850660

NPI Code Detail

MEDICARE: DR. DAVID PETER SPEACH M.D.

MEDICARE: DR. DAVID PETER SPEACH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	179673	NY
2	204R00000X	Electrodiagnostic Medicine Physician	01085922A	IN
3	208100000X	Physical Medicine & Rehabilitation Physician	01085922A	IN
4	2081N0008X	Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician	01085922A	IN
5	208100000X	Physical Medicine & Rehabilitation Physician	179673	NY

General Provider Information

NPI Number	:	1003850660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID PETER SPEACH M.D.

Provider Business Mailing Address
First Line	:	3600 W BETHEL AVE
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47304-5407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	60160 BODNAR BLVD
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46544-9338
Country	:	US
Telephone Number	:	574-247-9441
Fax Number	:	574-247-9442

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	05/26/2026

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Directions to “ DR. DAVID PETER SPEACH M.D.” Practice Location

Language	Start Address	Practice Location

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