Provider Demographics
NPI:1639172398
Name:ISAACS, DAVID LOUIS (RPH CDM)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LOUIS
Last Name:ISAACS
Suffix:
Gender:M
Credentials:RPH CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 CAMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3733
Mailing Address - Country:US
Mailing Address - Phone:440-461-5484
Mailing Address - Fax:216-297-2003
Practice Address - Street 1:1929 CAMBERLY DR
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-3733
Practice Address - Country:US
Practice Address - Phone:440-461-5484
Practice Address - Fax:216-297-2003
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-10770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist