Provider Demographics
NPI:1518162031
Name:KAUFMAN, DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:WALLS-KAUFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:411 E CAPITOL ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3864
Mailing Address - Country:US
Mailing Address - Phone:202-544-6035
Mailing Address - Fax:202-544-1632
Practice Address - Street 1:411 E CAPITOL ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3864
Practice Address - Country:US
Practice Address - Phone:202-544-6035
Practice Address - Fax:202-544-1632
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH21055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC199654Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID