Healthcare Provider Details

I. General information

NPI: 1255335683
Provider Name (Legal Business Name): DAVID MARK KAMINSKY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8505 FENTON ST STE 204
SILVER SPRING MD
20910-4499
US

IV. Provider business mailing address

8505 FENTON ST STE 204
SILVER SPRING MD
20910-4499
US

V. Phone/Fax

Practice location:
  • Phone: 301-587-7555
  • Fax:
Mailing address:
  • Phone: 301-587-7555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number01978
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: