Provider Demographics
NPI:1134210586
Name:HESTER, DARRELL E (MD)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:E
Last Name:HESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1915 S 17TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6682
Mailing Address - Country:US
Mailing Address - Phone:910-251-8200
Mailing Address - Fax:910-251-8204
Practice Address - Street 1:1915 S 17TH ST STE 101
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6682
Practice Address - Country:US
Practice Address - Phone:910-251-8200
Practice Address - Fax:910-251-8204
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC34349207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1134210586Medicaid
NC1134210586Medicaid
NC2202952AMedicare ID - Type Unspecified