Provider Demographics
NPI:1619957396
Name:KAPLAN, DAVID C (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:KAPLAN
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 1:38935 ANN ARBOR ROAD
Mailing Address - Street 2:CREDENTIALING/PAYOR CONTRACTING SERVICES
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3397
Mailing Address - Country:US
Mailing Address - Phone:734-632-0175
Mailing Address - Fax:734-632-0182
Practice Address - Street 1:601 PARK STREET, EMERGENCY MEDICINE DEPT
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1455
Practice Address - Country:US
Practice Address - Phone:870-253-8140
Practice Address - Fax:870-253-8633
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98-00074207P00000X, 207R00000X
PAMD052101L207P00000X
OH35-066777207P00000X, 207R00000X
NY208218-1207P00000X, 207R00000X
PAMD-052101-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
12321157OtherCAQH
NCF79301Medicare UPIN