Provider Demographics
NPI:1558352195
Name:VARNEY, DAVID ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLEN
Last Name:VARNEY
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 1:117. PROFESSIONAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-3220
Mailing Address - Country:US
Mailing Address - Phone:252-308-6889
Mailing Address - Fax:252-308-0049
Practice Address - Street 1:117. PROFESSIONAL DRIVE
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-3220
Practice Address - Country:US
Practice Address - Phone:252-308-6889
Practice Address - Fax:252-308-0049
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20856208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8984972Medicaid
NC211155Medicare ID - Type Unspecified
NC8984972Medicaid