Provider Demographics
NPI:1821082280
Name:DAGGS, FAITH DEVINE (MD)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:DEVINE
Last Name:DAGGS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:DEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2909 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4009
Practice Address - Country:US
Practice Address - Phone:336-277-0340
Practice Address - Fax:336-794-9411
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-00583207V00000X
SC89157207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH19546Medicare UPIN