Provider Demographics
NPI:1881670164
Name:KONSTANDT, DAVID BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BENJAMIN
Last Name:KONSTANDT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9735 KINCEY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9118
Mailing Address - Country:US
Mailing Address - Phone:704-414-2870
Mailing Address - Fax:704-414-2860
Practice Address - Street 1:128 MEDICAL PARK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8578
Practice Address - Country:US
Practice Address - Phone:704-660-3322
Practice Address - Fax:704-660-3330
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2021-05-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200500344174400000X
NC2005-00344208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902364Medicaid
NC5902364Medicaid
NC2040950BMedicare UPIN