Provider Demographics
NPI:1023161106
Name:FISHKIN, DAVID B (DC,MPH)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:FISHKIN
Suffix:
Gender:M
Credentials:DC,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W EDMONSTON DR
Mailing Address - Street 2:SUITE 602
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1228
Mailing Address - Country:US
Mailing Address - Phone:301-444-4890
Mailing Address - Fax:301-444-4893
Practice Address - Street 1:50 W EDMONSTON DR
Practice Address - Street 2:SUITE 602
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1228
Practice Address - Country:US
Practice Address - Phone:301-444-4890
Practice Address - Fax:301-444-4893
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01465111N00000X
VA0104000956111N00000X
DCCH20038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD18970001OtherCAREFIRST
DC18970001OtherCAREFIRST
MD4324466OtherAETNA
MD699834Medicare ID - Type Unspecified
MDU26713Medicare UPIN
MD699834Medicare ID - Type Unspecified