Provider Demographics
NPI:1316058100
Name:BACHOFER, DAVID EDWARD (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
Last Name:BACHOFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ANA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1750
Mailing Address - Country:US
Mailing Address - Phone:256-767-5940
Mailing Address - Fax:256-767-5943
Practice Address - Street 1:204 ANA DR
Practice Address - Street 2:SUITE B
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1750
Practice Address - Country:US
Practice Address - Phone:256-767-5940
Practice Address - Fax:256-767-5943
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL23750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-39971OtherBCBS
H30311Medicare UPIN
AL515-39971OtherBCBS