Individual
DAVID ARTHUR VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
747 S HILL ST, GRIFFIN, GA 30224-4830
(770) 228-5407
(770) 227-1430
Mailing address
747 S HILL ST, GRIFFIN, GA 30224-4830
(770) 228-5407
(770) 227-1430
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29545
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00391377A
—
GA
01
—
2723329P01
CIGNA PROVIDER NUMBER
GA
01
—
52023547
BCBS PROVIDER NUMBER
GA
Enumeration date
12/12/2006
Last updated
11/16/2014
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