Provider Demographics
NPI:1407993207
Name:BAUGH, DAVID GRAY (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GRAY
Last Name:BAUGH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 CARLYS WAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8534
Mailing Address - Country:US
Mailing Address - Phone:336-315-0560
Mailing Address - Fax:336-279-8354
Practice Address - Street 1:2101 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-5111
Practice Address - Country:US
Practice Address - Phone:336-273-0596
Practice Address - Fax:336-279-8354
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist