Provider Demographics
NPI:1043281314
Name:GIVENS, DAVIDSON H (MD)
Entity Type:Individual
Prefix:
First Name:DAVIDSON
Middle Name:H
Last Name:GIVENS
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:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-277-2000
Mailing Address - Fax:336-277-2050
Practice Address - Street 1:186 KIMEL PARK DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6946
Practice Address - Country:US
Practice Address - Phone:336-277-2000
Practice Address - Fax:336-277-2050
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20905207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1043281314Medicaid
NC35668OtherBCBS ID#
NC8935671Medicaid
NC143OtherPARTNERS ID#
NC8935668Medicaid
NC1285682310OtherWSCA GRP NPI #
NCAG7195705OtherDEA #
NC206651BMedicare PIN
NC143OtherPARTNERS ID#
NC8935671Medicaid
NC35668OtherBCBS ID#
NCC84071Medicare UPIN