MEDICARE: DR. DAVID JOHN POPLAWSKI MD, FACS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0420006166	VT
2	208800000X	Urology Physician	016102	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00005152	OTHER	VT	BCBS PROVIDER #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316010606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOHN POPLAWSKI MD, FACS

Provider Business Mailing Address
First Line	:	16 LONG SANDS RD
Second Line	:
City	:	YORK
State	:	ME
Zip	:	03909-1147
Country	:	US
Telephone Number	:	207-335-1397
Fax Number	:	207-351-3923

Provider Business Practice Location Address
First Line	:	16 LONG SANDS RD
Second Line	:
City	:	YORK
State	:	ME
Zip	:	03909-1147
Country	:	US
Telephone Number	:	207-351-3975
Fax Number	:	207-351-3923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/09/2010

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