Provider Demographics
NPI:1033180823
Name:TATE, DENNY C (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNY
Middle Name:C
Last Name:TATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 1/2 S. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-3320
Mailing Address - Country:US
Mailing Address - Phone:336-584-9366
Mailing Address - Fax:
Practice Address - Street 1:316 1/2 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-3320
Practice Address - Country:US
Practice Address - Phone:336-228-9759
Practice Address - Fax:336-227-2794
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC81652OtherBLUE CROSS
NC8981652Medicaid
NC9908OtherPARTNERS
NCC82187Medicare UPIN
NC81652OtherBLUE CROSS