Provider Demographics
NPI:1487956926
Name:ESPENSCHEID, DAVID WALTER (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WALTER
Last Name:ESPENSCHEID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1374 TIGER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-5725
Mailing Address - Country:US
Mailing Address - Phone:850-572-6188
Mailing Address - Fax:
Practice Address - Street 1:2257 N BAYLEN ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1703
Practice Address - Country:US
Practice Address - Phone:850-572-6188
Practice Address - Fax:850-462-9352
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108353207QA0505X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE11917Medicare UPIN