Provider Demographics
NPI:1811930589
Name:PIRRUNG, DAVID E (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:PIRRUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4495 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-3375
Mailing Address - Country:US
Mailing Address - Phone:904-384-5222
Mailing Address - Fax:904-384-6468
Practice Address - Street 1:4495 ROOSEVELT BLVD
Practice Address - Street 2:SUITE 316
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-3375
Practice Address - Country:US
Practice Address - Phone:904-384-5222
Practice Address - Fax:904-384-6468
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2014-02-21
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Provider Licenses
StateLicense IDTaxonomies
FLME11514207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16597VMedicare PIN
FLD52960Medicare UPIN