Individual
DAVID WALTER HACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 N CLAYTON ST, MSB SUITE 200, WILMINGTON, DE 19805-3165
(302) 575-8040
(302) 575-8005
Mailing address
PO BOX 824804, PHILADELPHIA, PA 19182-4804
(302) 575-8040
(302) 575-8005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C10005593
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000999301
—
DE
01
—
577489
AETNA USHC
—
01
—
P00096976
RR MEDICARE
—
Enumeration date
08/07/2006
Last updated
05/19/2021
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