Provider Demographics
NPI:1306847660
Name:HURST, DAVID MAURICE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MAURICE
Last Name:HURST
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 1:3801 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1301
Mailing Address - Country:US
Mailing Address - Phone:336-852-3300
Mailing Address - Fax:336-852-0651
Practice Address - Street 1:3801 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1301
Practice Address - Country:US
Practice Address - Phone:336-852-3300
Practice Address - Fax:336-852-0651
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15847204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8945085Medicaid
NC207471BMedicare ID - Type Unspecified
C84654Medicare UPIN