Provider Demographics
NPI:1235189119
Name:DEALY, DARILYN HEDDEN (MD)
Entity Type:Individual
Prefix:
First Name:DARILYN
Middle Name:HEDDEN
Last Name:DEALY
Suffix:
Gender:F
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 752005
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-2005
Mailing Address - Country:US
Mailing Address - Phone:828-274-6190
Mailing Address - Fax:828-277-4808
Practice Address - Street 1:68 SWEETEN CREEK RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2318
Practice Address - Country:US
Practice Address - Phone:828-255-0231
Practice Address - Fax:828-255-2880
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29101207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC205826CMedicare PIN
NC8928002Medicaid
C85486Medicare UPIN
NC205826AMedicare ID - Type Unspecified