Provider Demographics
NPI:1851394258
Name:THOMPSON, DAVID STUART (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:STUART
Last Name:THOMPSON
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 1:4810 S CROATAN HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-8504
Mailing Address - Country:US
Mailing Address - Phone:252-449-7373
Mailing Address - Fax:252-449-7371
Practice Address - Street 1:4810 S CROATAN HWY
Practice Address - Street 2:STE 100
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-8504
Practice Address - Country:US
Practice Address - Phone:252-449-7373
Practice Address - Fax:252-449-7371
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801531207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89126T1Medicaid
H27842Medicare UPIN
NC2280554AMedicare PIN