Provider Demographics
NPI:1306340609
Name:HUNT, DAVID WALTER III
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WALTER
Last Name:HUNT
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3437 BRUIN DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-4747
Mailing Address - Country:US
Mailing Address - Phone:757-328-7908
Mailing Address - Fax:
Practice Address - Street 1:3437 BRUIN DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-4747
Practice Address - Country:US
Practice Address - Phone:757-328-7908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA$$$$$$$$$Medicaid