Provider Demographics
NPI:1508028143
Name:TSYNMAN, DONALD N (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:N
Last Name:TSYNMAN
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 1:2210 HEMBY LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3789
Mailing Address - Country:US
Mailing Address - Phone:252-551-3000
Mailing Address - Fax:252-551-3100
Practice Address - Street 1:2210 HEMBY LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3789
Practice Address - Country:US
Practice Address - Phone:252-551-3000
Practice Address - Fax:252-551-3100
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT193973207R00000X
NY274934207RG0100X
NC2020-03042207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1508028143Medicaid