Provider Demographics
NPI:1942342399
Name:AULT, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:AULT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 R ST NW STE C9
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1647
Mailing Address - Country:US
Mailing Address - Phone:202-986-0371
Mailing Address - Fax:202-986-0412
Practice Address - Street 1:1800 R ST NW STE C9
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1647
Practice Address - Country:US
Practice Address - Phone:202-986-0371
Practice Address - Fax:202-986-0412
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD333672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC5181OtherHEALTHRIGHT(MEDICAID MCO)
DC281810OtherAMERIGROUP(MEDICAID MCO)
DC23653OtherCHARTERED HEALTH PLAN
DC23653OtherCHARTERED HEALTH PLAN
DCG01988G02Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER