1942342399 NPI number — DR. DAVID AULT M.D.

Table of content: DR. DAVID AULT M.D. (NPI 1942342399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942342399 NPI number — DR. DAVID AULT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AULT
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1942342399
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 R ST NW STE C9
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20009-1647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-986-0371
Provider Business Mailing Address Fax Number:
202-986-0412

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 R ST NW STE C9
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20009-1647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-986-0371
Provider Business Practice Location Address Fax Number:
202-986-0412
Provider Enumeration Date:
02/13/2007

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: 2084P0800X , with the licence number:  MD33367 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5181 . This is a "HEALTHRIGHT(MEDICAID MCO)" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 281810 . This is a "AMERIGROUP(MEDICAID MCO)" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 23653 . This is a "CHARTERED HEALTH PLAN" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".