Provider Demographics
NPI:1043243348
Name:TALMADGE, DAVID BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BENJAMIN
Last Name:TALMADGE
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 1:1 VA CENTER
Mailing Address - Street 2:TOGUS VA HOSPITAL DEPARTMENT OF RHEUMATOLOGY
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-6719
Mailing Address - Country:US
Mailing Address - Phone:207-623-8411
Mailing Address - Fax:207-621-7316
Practice Address - Street 1:1 VA CENTER
Practice Address - Street 2:TOGUS VA HOSPITAL DEPARTMENT OF RHEUMATOLOGY
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6719
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:207-621-7316
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME17834174400000X
NH12822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1011867Medicaid
ME432962199Medicaid
NH30205426Medicaid
ME0673610001OtherDMERC
MEP00637637OtherPALMETTO RAILROAD MEDICARE
ME0673610001OtherDMERC
MEI44339Medicare UPIN
VT1011867Medicaid