Provider Demographics
NPI:1225145089
Name:STALLINGS, DAVEY B (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVEY
Middle Name:B
Last Name:STALLINGS
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 1:110 EAST WALL ST
Mailing Address - Street 2:
Mailing Address - City:RURAL HALL
Mailing Address - State:NC
Mailing Address - Zip Code:27045
Mailing Address - Country:US
Mailing Address - Phone:336-659-9440
Mailing Address - Fax:336-659-9845
Practice Address - Street 1:110 E. WALL ST
Practice Address - Street 2:
Practice Address - City:RURAL HALL
Practice Address - State:NC
Practice Address - Zip Code:27045
Practice Address - Country:US
Practice Address - Phone:336-659-9440
Practice Address - Fax:336-659-9845
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10936207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCMEDICAIDMedicaid
NCBCBSOther79140
NCMEDICAIDMedicaid
NCC86572Medicare UPIN