Provider Demographics
NPI:1164465977
Name:VERST, DAVID BERNARD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BERNARD
Last Name:VERST
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 1:15 WEST GALENA ST
Mailing Address - Street 2:
Mailing Address - City:HAILEY
Mailing Address - State:ID
Mailing Address - Zip Code:83333
Mailing Address - Country:US
Mailing Address - Phone:208-788-7779
Mailing Address - Fax:208-788-7784
Practice Address - Street 1:15 WEST GALENA ST
Practice Address - Street 2:
Practice Address - City:HAILEY
Practice Address - State:ID
Practice Address - Zip Code:83333
Practice Address - Country:US
Practice Address - Phone:208-788-7779
Practice Address - Fax:208-788-7784
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM8207207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806197100Medicaid
IDH24785Medicare UPIN