Provider Demographics
NPI:1316010606
Name:POPLAWSKI, DAVID JOHN (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:POPLAWSKI
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LONG SANDS RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1147
Mailing Address - Country:US
Mailing Address - Phone:207-335-1397
Mailing Address - Fax:207-351-3923
Practice Address - Street 1:16 LONG SANDS RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1147
Practice Address - Country:US
Practice Address - Phone:207-351-3975
Practice Address - Fax:207-351-3923
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420006166174400000X
ME016102208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00005152OtherBCBS PROVIDER #
ME432756899Medicaid
VT0005152Medicaid
VT340001928Medicare ID - Type UnspecifiedRAILROAD MDICARE PROVIDER
VTVT9672Medicare ID - Type UnspecifiedPERF PROVIDER #
VTE41699Medicare UPIN
ME0000138Medicare PIN