Provider Demographics
NPI:1053343632
Name:STAPP, DAVID E (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:STAPP
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1941 BISHOP LN STE 1018
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1928
Mailing Address - Country:US
Mailing Address - Phone:502-456-6211
Mailing Address - Fax:502-456-4440
Practice Address - Street 1:1850 STATE ST
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4990
Practice Address - Country:US
Practice Address - Phone:502-456-6211
Practice Address - Fax:502-456-4440
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060245A207ZB0001X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200089290AMedicaid
KY64106164OtherKENTUCKY MEDICAID
KY50065168OtherPASSPORT
KY000000854062OtherANTHEM
IN200089290AMedicaid
I28543Medicare UPIN
IN000000358061OtherANTHEM BLUE CROSS BS
KY50007603OtherPASSPORT MEDICAID
KY64106164OtherKENTUCKY MEDICAID
KY000000854062OtherANTHEM
P00229558OtherRAILROAD MEDICARE
IN242390EMedicare PIN