Provider Demographics
NPI:1083613749
Name:PEARSON, DARREN J (MD)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:J
Last Name:PEARSON
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 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-1540
Mailing Address - Fax:
Practice Address - Street 1:6727 PARKER FARM DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3176
Practice Address - Country:US
Practice Address - Phone:910-772-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO106466207R00000X
NC2020-00922207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO110244371OtherRR MEDICARE
MO1121245OtherBLUE CROSS/BLUE SHIELD
MO126608OtherGROUP HEALTH PLAN
MO411630OtherHEALTHLINK
MOG94455Medicare UPIN
MO411630OtherHEALTHLINK