Provider Demographics
NPI:1336640788
Name:HERRING, DAVID BRIAN (PA-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BRIAN
Last Name:HERRING
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 BROAD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2662
Mailing Address - Country:US
Mailing Address - Phone:919-220-9800
Mailing Address - Fax:
Practice Address - Street 1:2400 BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2662
Practice Address - Country:US
Practice Address - Phone:919-220-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07926363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant