Provider Demographics
NPI:1306816558
Name:DULIN, NANCY L (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:DULIN
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 651711
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28265-1711
Mailing Address - Country:US
Mailing Address - Phone:704-873-0281
Mailing Address - Fax:
Practice Address - Street 1:218 OLD MOCKSVILLE RD
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-1930
Practice Address - Country:US
Practice Address - Phone:704-873-0281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201242207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900186Medicaid
NC2038034Medicare PIN
NCG11347Medicare UPIN