Provider Demographics
NPI:1871501015
Name:TAPPER, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:TAPPER
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 1:515 THOMPSON ST
Mailing Address - Street 2:# D
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5068
Mailing Address - Country:US
Mailing Address - Phone:336-627-5178
Mailing Address - Fax:336-627-0727
Practice Address - Street 1:515 THOMPSON ST
Practice Address - Street 2:#D
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5068
Practice Address - Country:US
Practice Address - Phone:336-627-5178
Practice Address - Fax:336-627-0727
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-81570Medicaid
NC235082GOtherMEDICARE GROUP PIN#
NC202649BMedicare PIN
NC235082GOtherMEDICARE GROUP PIN#