Provider Demographics
NPI:1215923255
Name:KALKSTEIN, DAVID (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:KALKSTEIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18947 JOHN J WILLIAMS HWY
Mailing Address - Street 2:STE 210
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4474
Mailing Address - Country:US
Mailing Address - Phone:302-478-7981
Mailing Address - Fax:302-644-1737
Practice Address - Street 1:1919 CHESTNUT ST
Practice Address - Street 2:APT 2002
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-3433
Practice Address - Country:US
Practice Address - Phone:610-716-3715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023723E2084P0800X
DEC1-00055162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1663245OtherBLUE SHIELD
PA1663245OtherBLUE SHIELD
PA046875M7XMedicare ID - Type Unspecified
DE000K36036Medicare ID - Type Unspecified
PAB96813Medicare UPIN
DE1663245OtherBLUE SHIELD