Organization
DAVID W. KOSSOFF, M.D., LLC
Active
Other names
Optimal Digestive Care
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN OLIVER (CEO)
(786) 530-3820
Entity
Organization
Contact information
Practice address
110 THOMAS JOHNSON DR STE 335, FREDERICK, MD 21702-4949
(301) 624-5566
(301) 624-5542
Mailing address
110 THOMAS JOHNSON DR STE 335, FREDERICK, MD 21702-4949
(301) 624-5566
(301) 624-5542
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0054121
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133102701
—
MD
01
—
376329
MDIPA OPT CHOICE
MD
01
—
4040001
CAREFIRST NAT CAP AREA
MD
01
—
494710
NCPPO
MD
01
—
682BDA
CAREFRIST OF MD
MD
01
—
P00206418
RAILROAD MEDICARE
MD
01
—
P10152
INFORMED
MD
Enumeration date
01/05/2007
Last updated
05/19/2025
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