Provider Demographics
NPI:1407835010
Name:RIBEIRO, DONALD A (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:A
Last Name:RIBEIRO
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 1:516 S WM HOOKER DR
Mailing Address - Street 2:
Mailing Address - City:HOOKERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28538-7188
Mailing Address - Country:US
Mailing Address - Phone:252-747-2089
Mailing Address - Fax:252-747-2734
Practice Address - Street 1:516 S WM HOOKER DR
Practice Address - Street 2:
Practice Address - City:HOOKERTON
Practice Address - State:NC
Practice Address - Zip Code:28538-7188
Practice Address - Country:US
Practice Address - Phone:252-747-2089
Practice Address - Fax:252-747-2734
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8971512Medicaid
NC5904152Medicaid
NC8971512Medicaid
NC5904152Medicaid
NC209899KMedicare PIN