Provider Demographics
NPI:1467481069
Name:HERINGTON, DAVID STICKEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STICKEL
Last Name:HERINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:505 W FLEMING DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3923
Mailing Address - Country:US
Mailing Address - Phone:828-438-8171
Mailing Address - Fax:828-438-1966
Practice Address - Street 1:505 W FLEMING DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3923
Practice Address - Country:US
Practice Address - Phone:828-438-8171
Practice Address - Fax:828-438-1966
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8941987Medicaid
NCC81967Medicare UPIN
NC203624AMedicare ID - Type Unspecified