Provider Demographics
NPI:1790785798
Name:ABERNETHY, DAVID LEE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
Last Name:ABERNETHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 794
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638-0794
Mailing Address - Country:US
Mailing Address - Phone:828-754-8482
Mailing Address - Fax:828-754-4456
Practice Address - Street 1:109 FAIRWAY SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NC
Practice Address - Zip Code:28638-2440
Practice Address - Country:US
Practice Address - Phone:828-754-8482
Practice Address - Fax:828-754-4456
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2023-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC20865207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8910034Medicaid
NCC81159Medicare UPIN
NC202244Medicare ID - Type Unspecified