Provider Demographics
NPI:1508875972
Name:VU, DAVIS D (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVIS
Middle Name:D
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 602658
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2658
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:336-277-7050
Practice Address - Street 1:1930 PEACE HAVEN RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-4817
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:336-277-7050
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200400093207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909318Medicaid
NCNC8626AMedicare PIN
I40765Medicare UPIN