Provider Demographics
NPI:1942200100
Name:POSNER, DAVID MARK (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARK
Last Name:POSNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:MARK
Other - Last Name:POSNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4348 WILD FILLY CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5931
Mailing Address - Country:US
Mailing Address - Phone:410-461-4800
Mailing Address - Fax:410-461-4802
Practice Address - Street 1:4348 WILD FILLY CT
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-5931
Practice Address - Country:US
Practice Address - Phone:410-461-4800
Practice Address - Fax:410-461-4802
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH15121207P00000X
KY01958207Q00000X
MDH0015121207P00000X
CAC38375207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCD75289Medicare UPIN
VAD75289Medicare UPIN
MDD75289Medicare UPIN
D75289Medicare UPIN