Provider Demographics
NPI:1699711911
Name:HERF, DAVID ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLEN
Last Name:HERF
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 1:435 BROOKMEADE DR
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-7304
Mailing Address - Country:US
Mailing Address - Phone:850-682-0409
Mailing Address - Fax:850-689-1696
Practice Address - Street 1:435 BROOKMEADE DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-7304
Practice Address - Country:US
Practice Address - Phone:850-682-0409
Practice Address - Fax:850-689-1696
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12552208600000X
FLME0043630208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068340000Medicaid
46162Medicare ID - Type Unspecified
D54973Medicare UPIN