Provider Demographics
NPI:1376547356
Name:PARKER, DAVID R (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1248 FORT BRAGG RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-4981
Mailing Address - Country:US
Mailing Address - Phone:910-486-6818
Mailing Address - Fax:910-484-1099
Practice Address - Street 1:1248 FORT BRAGG RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-4981
Practice Address - Country:US
Practice Address - Phone:910-486-6818
Practice Address - Fax:910-484-1099
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2017-04-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200300678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00419380OtherRAILROAD MEDICARE
NC891363VMedicaid
NC138A6OtherDR PARKER'S BCBS OF NC #
NC89138A6Medicaid
NC891363VMedicaid
NCI13823Medicare UPIN
NC891363VMedicaid