Individual
DR. DAVID JOHN DE HARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4811 SW THISTLE TER, PALM CITY, FL 34990-3948
(772) 971-5111
(281) 337-2611
Mailing address
4811 SW THISTLE TER, PALM CITY, FL 34990-3948
(772) 971-5111
(281) 337-2611
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
ME0071228
FL
2085R0001X
Radiation Oncology Physician
Primary
ME71228
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252150400
—
FL
01
—
32407
BCBS
FL
01
—
920004980
RAILROAD MEDICARE
FL
Enumeration date
11/02/2005
Last updated
05/11/2017
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