MEDICARE: MAX H DAVID MD

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	207RI0200X	Infectious Disease Physician	2000170414	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P0004834	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	179412	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629159413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAX H DAVID MD

Provider Business Mailing Address
First Line	:	8790 WATSON RD
Second Line	:	SUITE 201
City	:	SAINT LOUIS
State	:	MO
Zip	:	63119-5140
Country	:	US
Telephone Number	:	314-543-2800
Fax Number	:	314-543-2801

Provider Business Practice Location Address
First Line	:	8790 WATSON RD
Second Line	:	SUITE 201
City	:	SAINT LOUIS
State	:	MO
Zip	:	63119-5140
Country	:	US
Telephone Number	:	314-543-2800
Fax Number	:	314-543-2801

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	03/30/2011

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Directions to “ MAX H DAVID MD” Practice Location

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