Provider Demographics
NPI:1396805081
Name:DRUSKIN, DAVID M (PA C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:DRUSKIN
Suffix:
Gender:M
Credentials:PA C
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:PPQA MEDICARE COMPLIANCE UNIT 6 WESTQ
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:10810 CONNECTICUT AVENUE
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2138
Practice Address - Country:US
Practice Address - Phone:301-929-7507
Practice Address - Fax:301-929-7114
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2010-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDC0000472111NX0100X
PAMA002389L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
011995M92Medicare ID - Type Unspecified
P82342Medicare UPIN