Provider Demographics
NPI:1801842794
Name:KONANC, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:KONANC
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:RALEIGH NEUROLOGY ASSOCIATES, PA
Mailing Address - Street 2:1540 SUNDAY DR.
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-5163
Mailing Address - Country:US
Mailing Address - Phone:919-782-3456
Mailing Address - Fax:
Practice Address - Street 1:RALEIGH NEUROLOGY ASSOCIATES, PA
Practice Address - Street 2:1540 SUNDAY DR.
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5163
Practice Address - Country:US
Practice Address - Phone:919-782-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93-005062084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891050QMedicaid
NC891050QMedicaid
NC2236566Medicare ID - Type Unspecified
NC1801842794Medicare PIN