Provider Demographics
NPI:1174590863
Name:NABERT, DAVID R (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:NABERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:922 NORTHSIDE DR E
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-2168
Mailing Address - Country:US
Mailing Address - Phone:912-489-6246
Mailing Address - Fax:912-489-6346
Practice Address - Street 1:5 GRADY JOHNSON RD
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-6026
Practice Address - Country:US
Practice Address - Phone:912-489-6246
Practice Address - Fax:912-489-6346
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056903207RC0000X, 207RC0001X, 207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA489831463DMedicaid
GA06BDJCJMedicare PIN
GAP00726731Medicare PIN
GA06BDJCJMedicare PIN
GAP00726731Medicare PIN
FLP00134173OtherRAILROAD MEDICARE
GA489831463AMedicaid