Organization
DIGESTIVE HEALTH SPECIALISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FAITH Y TRADD (PRACTICE ADMINISTRATOR)
(386) 822-9410
Entity
Organization
Contact information
Practice address
1070 N STONE ST, STE D, DELAND, FL 32720-0824
(386) 822-9410
(386) 469-0045
Mailing address
1070 N STONE ST, STE D, DELAND, FL 32720-0824
(386) 822-9410
(386) 469-0045
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME36213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
593256803
FEI #
—
Enumeration date
06/20/2005
Last updated
07/14/2008
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