Provider Demographics
NPI:1215938618
Name:SHOWALTER, DAVID PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:SHOWALTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:600 N CATTLEMEN RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6410
Mailing Address - Country:US
Mailing Address - Phone:941-371-6565
Mailing Address - Fax:941-377-7731
Practice Address - Street 1:600 N CATTLEMEN RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6410
Practice Address - Country:US
Practice Address - Phone:941-371-6565
Practice Address - Fax:941-377-7731
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME601582086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650501582OtherTAX ID
FL12342OtherBCBC
FL372697500Medicaid
FL060063668OtherMEDICARE RR
FL650501582OtherTAX ID
FL372697500Medicaid