Provider Demographics
NPI:1619923935
Name:DAHLKAMP, DAVID EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:DAHLKAMP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 HIGHWAY 44 E
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6001
Mailing Address - Country:US
Mailing Address - Phone:502-543-2225
Mailing Address - Fax:502-921-4528
Practice Address - Street 1:149 HIGHWAY 44 E
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6001
Practice Address - Country:US
Practice Address - Phone:502-543-2225
Practice Address - Fax:502-921-4528
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4986111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2784908000OtherPASSPORT ADVANTAGE
KY7084891OtherAETNA
KY11658805OtherCAQH
KY50012854OtherPASSPORT
KY000000511278OtherANTHEM BLUE CROSS BLUE SHIELD
KY000000511278OtherANTHEM BLUE CROSS BLUE SHIELD
KY0907603Medicare PIN