Provider Demographics
NPI:1053311613
Name:HUNDT, DAVID GORDON (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:GORDON
Last Name:HUNDT
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 1:227 MCLAWS CIR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5649
Mailing Address - Country:US
Mailing Address - Phone:757-564-8182
Mailing Address - Fax:757-564-0077
Practice Address - Street 1:227 MCLAWS CIR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5649
Practice Address - Country:US
Practice Address - Phone:757-564-8182
Practice Address - Fax:757-564-0077
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232252207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0007654510OtherAETNA
432036941OtherVIRGINIA HEALTH NETWORK
VA103076OtherANTHEM
73848OtherSENTARA OPTIMA
432036941OtherCHAMPUS / TRICARE
432036941OtherPRIVATE HEALTHCARE SYSTEM
VA1971416OtherCIGNA
P00131829OtherRAILROAD MEDICARE
73848OtherSENTARA OPTIMA