Provider Demographics
NPI:1396877791
Name:TODD, DAVID F (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:TODD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7253 AMBASSADOR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2710
Mailing Address - Country:US
Mailing Address - Phone:443-436-1116
Mailing Address - Fax:443-436-1256
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:SUITE 235
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3046
Practice Address - Country:US
Practice Address - Phone:410-266-2770
Practice Address - Fax:410-841-6251
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD649222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1073OtherAAD BCBS REGIONAL PLANS
MDCA1932OtherRR MEDICARE AAD GROUP PTAN
MD1073OtherAAD BLUE CHOICE
MDCN6292OtherRR MEDICARE SHIPLEYS GROUP PTAN
MDP00897482OtherRR MEDICARE AAD PROVIDER PTAN
MDS645OtherAAD BCBS
MD171724OtherMEDICARE ARA PTAN
MD412929600Medicaid
MDP00895755OtherRR MEDICARE SHIPLEYS PROVIDER PTAN
P00473397Medicare PIN
527LS247Medicare PIN