Healthcare Provider Details

I. General information

NPI: 1215680780
Provider Name (Legal Business Name): DAVID L. TROTTER MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 W BELMONT AVE
CHICAGO IL
60657-4401
US

IV. Provider business mailing address

855 W BELMONT AVE
CHICAGO IL
60657-4401
US

V. Phone/Fax

Practice location:
  • Phone: 202-276-8191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID TROTTER
Title or Position: SOLE MEMBER
Credential: MD
Phone: 202-276-8191