Provider Demographics
NPI:1659358224
Name:CARPENTER, DAVID C (AUD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 EAST MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1542
Mailing Address - Country:US
Mailing Address - Phone:330-762-8959
Mailing Address - Fax:330-762-9121
Practice Address - Street 1:395 EAST MARKET STREET
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1542
Practice Address - Country:US
Practice Address - Phone:330-762-8959
Practice Address - Fax:330-762-9121
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00435231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2160432Medicaid
OH2160432Medicaid
CA0898351Medicare ID - Type Unspecified