Provider Demographics
NPI:1306946306
Name:GERMAN, DAVID C (MD PSC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:GERMAN
Suffix:
Gender:M
Credentials:MD PSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N RACE ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3454
Mailing Address - Country:US
Mailing Address - Phone:270-659-3381
Mailing Address - Fax:270-659-3383
Practice Address - Street 1:1301 N RACE ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3454
Practice Address - Country:US
Practice Address - Phone:270-659-3381
Practice Address - Fax:270-659-3383
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29922207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000051324OtherBLUE CROSS
KY64299225Medicaid
KY64299225Medicaid
KY1596901Medicare ID - Type Unspecified