Provider Demographics
NPI:1750351359
Name:KNOPF, DAVID R (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:KNOPF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7505 WATERS AVE
Mailing Address - Street 2:STE. C8
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3825
Mailing Address - Country:US
Mailing Address - Phone:912-352-2606
Mailing Address - Fax:912-352-0623
Practice Address - Street 1:5354 REYNOLDS ST
Practice Address - Street 2:STE 102
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6007
Practice Address - Country:US
Practice Address - Phone:912-355-2116
Practice Address - Fax:912-355-3653
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0251992085R0202X
SC157732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG25199Medicaid
FL908957800Medicaid
GA00303751AMedicaid
LA1784494Medicaid
GA235405OtherBCBSGA
SCG25199Medicaid
FL908957800Medicaid
GA30BDNCMMedicare PIN