Provider Demographics
NPI:1245415132
Name:PEARCE, DANIEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:PEARCE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1450 PROFESSIONAL PARK DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1300
Mailing Address - Country:US
Mailing Address - Phone:336-724-2434
Mailing Address - Fax:336-716-6761
Practice Address - Street 1:1450 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE 150
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1300
Practice Address - Country:US
Practice Address - Phone:336-724-2434
Practice Address - Fax:336-716-6761
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2016-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200400729207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909608Medicaid
NC5909608Medicaid