Provider Demographics
NPI:1033112875
Name:BOONE, DAVID W (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:BOONE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3001 EDWARDS MILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5243
Mailing Address - Country:US
Mailing Address - Phone:919-781-5600
Mailing Address - Fax:919-863-6821
Practice Address - Street 1:3001 EDWARDS MILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5243
Practice Address - Country:US
Practice Address - Phone:919-781-5600
Practice Address - Fax:919-782-6578
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2021-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC94-00425207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F62528Medicare UPIN