Provider Demographics
NPI:1902105174
Name:DE GIVE, DAVID PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PHILIP
Last Name:DE GIVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 NW RICHMOND BEACH RD
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3101
Mailing Address - Country:US
Mailing Address - Phone:206-546-2421
Mailing Address - Fax:206-542-9028
Practice Address - Street 1:357 NW RICHMOND BEACH RD
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-3101
Practice Address - Country:US
Practice Address - Phone:206-546-2421
Practice Address - Fax:206-542-9028
Is Sole Proprietor?:No
Enumeration Date:2011-03-27
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10037326208000000X
ORMD169273208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500673066Medicaid