Provider Demographics
NPI:1235183369
Name:QUIMBY, DAVID S (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:QUIMBY
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 1:7710 MERCY RD STE 3000
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2350
Mailing Address - Country:US
Mailing Address - Phone:402-717-0759
Mailing Address - Fax:402-717-0770
Practice Address - Street 1:7710 MERCY RD STE 3000
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2350
Practice Address - Country:US
Practice Address - Phone:402-717-0759
Practice Address - Fax:402-717-0770
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA37651207RI0200X
NE23531207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47081309213Medicaid
IA0719955Medicaid
SD7721460Medicaid
NE$$$$$$$$$OtherCHAMPUS
SD7721460Medicaid
NEP00319740Medicare PIN
NECI1685Medicare PIN