Provider Demographics
NPI:1265584874
Name:DUFOUR, CLAUDE P (PAC)
Entity type:Individual
Prefix:MR
First Name:CLAUDE
Middle Name:P
Last Name:DUFOUR
Suffix:
Gender:M
Credentials:PAC
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 1528
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-1528
Mailing Address - Country:US
Mailing Address - Phone:910-642-6121
Mailing Address - Fax:910-642-8457
Practice Address - Street 1:823 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472
Practice Address - Country:US
Practice Address - Phone:910-642-6121
Practice Address - Fax:910-642-8457
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100591363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC82478OtherBLUE CROSS OF NC
NC0120143OtherUNITED HEALTH CARE
NC110017485OtherRR MCR
NC8982478Medicaid
SCN20979OtherSC MCD
NC0120143OtherUNITED HEALTH CARE
NC8982478Medicaid