Provider Demographics
NPI:1275748386
Name:KASHMER, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:KASHMER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:770-219-8440
Practice Address - Street 1:1 GUTHRIE SQ
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840
Practice Address - Country:US
Practice Address - Phone:570-887-4998
Practice Address - Fax:570-887-4744
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD437006208600000X
GA0787792086S0127X, 2086S0102X
FLME1187682086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03262939Medicaid
FLPENDINGOtherMEDICARE
PA1025026680001Medicaid