Provider Demographics
NPI:1396902805
Name:TUSHAR, DAVID ROBERT (PT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ROBERT
Last Name:TUSHAR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 GREENBRIAR CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-8622
Mailing Address - Country:US
Mailing Address - Phone:919-942-4518
Mailing Address - Fax:
Practice Address - Street 1:1101 WEAVER DAIRY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1538
Practice Address - Country:US
Practice Address - Phone:919-966-4915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2314174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist