Provider Demographics
NPI:1265416382
Name:TODOROFF, DAVID STEVEN (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STEVEN
Last Name:TODOROFF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:BIGLERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17307-0526
Mailing Address - Country:US
Mailing Address - Phone:717-677-9288
Mailing Address - Fax:717-677-4196
Practice Address - Street 1:6100 OLD JONESTOWN RD
Practice Address - Street 2:STE B
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2632
Practice Address - Country:US
Practice Address - Phone:717-541-0988
Practice Address - Fax:717-541-8838
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002799L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010531430005Medicaid
PA0010531430006Medicaid
PA0010531430007Medicaid
PA130116Medicare ID - Type Unspecified
PA0010531430006Medicaid
PA1149270004Medicare NSC
PA0010531430007Medicaid
PA1149270003Medicare NSC