Provider Demographics
NPI:1033283650
Name:ALDRICH, DAVID K (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:436 NOKOMIS AVE S
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2617
Mailing Address - Country:US
Mailing Address - Phone:941-488-7742
Mailing Address - Fax:941-484-7756
Practice Address - Street 1:436 NOKOMIS AVE S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2617
Practice Address - Country:US
Practice Address - Phone:941-488-7742
Practice Address - Fax:941-484-7756
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME21203208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00778OtherBLUE CROSS BLUE SHIELD GROUP
FL020012688OtherRAILROAD MEDICARE
FL303424OtherUNITED HEALTH CARE MPIN
FL12605OtherUNIVERSAL HEALTH CARE
FL58238OtherBCBS
FL0450305OtherCIGNA
FL0005052084OtherAETNA
FL59-1362995OtherGROUP TAX IDENTIFICATION
FL12605OtherUNIVERSAL HEALTH CARE
FL59-1362995OtherGROUP TAX IDENTIFICATION
FL0450305OtherCIGNA