Provider Demographics
NPI:1891888780
Name:CLAPP, DAVID WADE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WADE
Last Name:CLAPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 778912
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-8912
Mailing Address - Country:US
Mailing Address - Phone:317-777-6435
Mailing Address - Fax:317-777-6644
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:RI 5900
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-944-7812
Practice Address - Fax:317-944-4471
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2024-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN010325582080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100177250Medicaid
E94276Medicare UPIN
145590JMedicare ID - Type Unspecified