Provider Demographics
NPI:1962477877
Name:TESTORI, DOUGLAS J (DO)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:J
Last Name:TESTORI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 602484
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2484
Mailing Address - Country:US
Mailing Address - Phone:910-763-0291
Mailing Address - Fax:910-763-0291
Practice Address - Street 1:1520 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7356
Practice Address - Country:US
Practice Address - Phone:910-763-5182
Practice Address - Fax:910-763-0291
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2005-00851207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00347861OtherRAILROAD MEDICARE
NC5901092Medicaid
SCQ0085RMedicaid
NC1962477877Medicaid
NC8901740Medicaid
NC8901740Medicaid
NC2402611AMedicare PIN
NCP00347861OtherRAILROAD MEDICARE