Provider Demographics
NPI:1578566592
Name:DEWHURST, DONALD A II (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:A
Last Name:DEWHURST
Suffix:II
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 1:1830 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-6778
Mailing Address - Country:US
Mailing Address - Phone:828-349-2081
Mailing Address - Fax:828-524-6154
Practice Address - Street 1:1830 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-6778
Practice Address - Country:US
Practice Address - Phone:828-349-2081
Practice Address - Fax:828-524-6154
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20121207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1017HOtherBCBS
NC8928403Medicaid
NC1017HOtherDR DEWHURST'S BCBS OF NC
NCC83527Medicare UPIN
NC205911GMedicare ID - Type UnspecifiedDR DEWHURST'S MEDICARE #