Provider Demographics
NPI:1164407771
Name:PIERCE, HUBERT G (MD)
Entity Type:Individual
Prefix:
First Name:HUBERT
Middle Name:G
Last Name:PIERCE
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 1:701 DOCTORS DRIVE
Mailing Address - Street 2:SUITE N
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501
Mailing Address - Country:US
Mailing Address - Phone:252-559-2200
Mailing Address - Fax:252-522-5662
Practice Address - Street 1:701 DOCTORS DRIVE
Practice Address - Street 2:SUITE N
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501
Practice Address - Country:US
Practice Address - Phone:252-559-2200
Practice Address - Fax:252-522-5662
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11241207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
112845728OtherRAILROAD MEDICARE
NC8967740Medicaid
209584AMedicare ID - Type Unspecified
C85989Medicare UPIN