1619957396 NPI number — DAVID C KAPLAN MD

Table of content: DAVID C KAPLAN MD (NPI 1619957396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619957396 NPI number — DAVID C KAPLAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAPLAN
Provider First Name:
DAVID
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619957396
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
38935 ANN ARBOR ROAD
Provider Second Line Business Mailing Address:
CREDENTIALING/PAYOR CONTRACTING SERVICES
Provider Business Mailing Address City Name:
LIVONIA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48150-3397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-632-0175
Provider Business Mailing Address Fax Number:
734-632-0182

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 PARK STREET, EMERGENCY MEDICINE DEPT
Provider Second Line Business Practice Location Address:
EMERGENCY MEDICINE DEPARTMENT
Provider Business Practice Location Address City Name:
HONESDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18431-1455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-253-8140
Provider Business Practice Location Address Fax Number:
870-253-8633
Provider Enumeration Date:
01/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  98-00074 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: MD052101L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 35-066777 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 208218-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 98-00074 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 35-066777 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: MD-052101-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: 208218-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12321157 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".