Provider Demographics
NPI:1871769174
Name:ABBOTT, DAVID W (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:ABBOTT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1919 ELM ST N
Mailing Address - Street 2:UND DEPT CLINICAL NEUROSCIENCE
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-2416
Mailing Address - Country:US
Mailing Address - Phone:701-293-4113
Mailing Address - Fax:701-293-4109
Practice Address - Street 1:1919 ELM ST N
Practice Address - Street 2:UND DEPT CLINICAL NEUROSCIENCE
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2416
Practice Address - Country:US
Practice Address - Phone:701-293-4113
Practice Address - Fax:701-293-4109
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
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Provider Licenses
StateLicense IDTaxonomies
ND38532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry