Provider Demographics
NPI:1427078344
Name:CHATFIELD, DAVID W
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:CHATFIELD
Suffix:
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 1:478 E ALTAMONTE DR # 108 # 410
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4628
Mailing Address - Country:US
Mailing Address - Phone:407-767-0727
Mailing Address - Fax:407-767-0750
Practice Address - Street 1:740 FLORIDA CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-7651
Practice Address - Country:US
Practice Address - Phone:407-767-0727
Practice Address - Fax:407-767-0750
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7683207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00275218OtherRAILROAD MEDICARE
FL01950OtherBLUE CROSS BLUE SHIELD
FL01950OtherBLUE CROSS BLUE SHIELD
FLP00275218OtherRAILROAD MEDICARE
FL01950XMedicare ID - Type UnspecifiedMCR