Provider Demographics
NPI:1508867474
Name:DONALDSON, DAVID SCOTT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 CROOKED CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-6822
Mailing Address - Country:US
Mailing Address - Phone:828-329-8341
Mailing Address - Fax:
Practice Address - Street 1:318 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1521
Practice Address - Country:US
Practice Address - Phone:864-438-6811
Practice Address - Fax:864-280-7753
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC85325208800000X
NC9900033208800000X
VA0101277306208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911900Medicaid
SCN00034Medicaid
NC2271152EMedicare ID - Type Unspecified
NC8911900Medicaid