Provider Demographics
NPI:1932184215
Name:HERRINGTON, DAVID MCLEOD (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MCLEOD
Last Name:HERRINGTON
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:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27102-0344
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39151207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ39151Medicaid
NC7941997Medicaid
WV2005630000Medicaid
NC41997OtherBCBS
NC32659OtherPARTNERS
4581700OtherAETNA
NC52521OtherMEDCOST
VA6067450Medicaid
VA6067450Medicaid
NC52521OtherMEDCOST
WV2005630000Medicaid
NC2069233AMedicare PIN