Provider Demographics
NPI:1629019856
Name:BIVINS, DON HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:HOWARD
Last Name:BIVINS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:105 N CRUTCHFIELD ST # 2
Mailing Address - Street 2:
Mailing Address - City:DOBSON
Mailing Address - State:NC
Mailing Address - Zip Code:27017-8804
Mailing Address - Country:US
Mailing Address - Phone:336-789-2922
Mailing Address - Fax:336-789-0856
Practice Address - Street 1:7599 CARROLLTON PIKE STE C
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-6801
Practice Address - Country:US
Practice Address - Phone:276-728-1030
Practice Address - Fax:276-728-1041
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2024-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9801256207R00000X, 207RH0002X, 2084N0400X
VA0101029470207R00000X, 2084N0400X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB05086Medicare UPIN