Provider Demographics
NPI:1790923308
Name:PROPST, DAVID C (PA-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:PROPST
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 NASH ST N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1232
Mailing Address - Country:US
Mailing Address - Phone:252-237-5237
Mailing Address - Fax:252-234-9932
Practice Address - Street 1:3302 NASH ST N
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1232
Practice Address - Country:US
Practice Address - Phone:252-237-5237
Practice Address - Fax:252-234-9932
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01705363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902803Medicaid
NC2339535Medicare PIN