Individual
DAVID M REVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. O.
Contact information
Practice address
171 CHAPEL VIEW DR, REINHOLDS, PA 17569-0119
(717) 336-5824
(717) 336-5401
Mailing address
171 CHAPEL VIEW DR, P. O. BOX 119, REINHOLDS, PA 17569-0119
(717) 336-5824
(717) 336-5401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS005938L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011813120004
—
PA
01
—
4641800
AETNA
—
01
—
50051246
CAPITAL BLUE
—
01
—
542115
BLUE SHIELD
—
01
—
5838474
USH/HMO
—
01
—
P00262037
RAILROAD MEDICARE
—
01
—
P005066
GATEWAY
—
Enumeration date
08/31/2006
Last updated
06/14/2011
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