Healthcare Provider Details

I. General information

NPI: 1659358224
Provider Name (Legal Business Name): DAVID C CARPENTER AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 EAST MARKET STREET
AKRON OH
44304-1542
US

IV. Provider business mailing address

395 EAST MARKET STREET
AKRON OH
44304-1542
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-8959
  • Fax: 330-762-9121
Mailing address:
  • Phone: 330-762-8959
  • Fax: 330-762-9121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA00435
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: