Provider Demographics
NPI:1457335028
Name:BERRY, DAVID DON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DON
Last Name:BERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 1305
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-1305
Mailing Address - Country:US
Mailing Address - Phone:828-345-0877
Mailing Address - Fax:828-345-0514
Practice Address - Street 1:352 2ND ST NW
Practice Address - Street 2:STE 205
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-4960
Practice Address - Country:US
Practice Address - Phone:828-345-0877
Practice Address - Fax:828-345-0514
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC302882080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC30288Medicaid
NC30288Medicaid