Provider Demographics
NPI:1922097559
Name:HOPPER, DAVID HERSHEY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HERSHEY
Last Name:HOPPER
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:PO BOX 281
Mailing Address - Street 2:
Mailing Address - City:WENTWORTH
Mailing Address - State:NC
Mailing Address - Zip Code:27375-0281
Mailing Address - Country:US
Mailing Address - Phone:336-427-9022
Mailing Address - Fax:336-427-9030
Practice Address - Street 1:2150 NC HIGHWAY 65
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-9609
Practice Address - Country:US
Practice Address - Phone:336-427-9022
Practice Address - Fax:336-427-9030
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20917207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0056225000Medicaid
A72049Medicare UPIN
WV0056225000Medicaid
WV0056225000Medicaid