Provider Demographics
NPI:1952393605
Name:SEALES, DAVID M (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:SEALES
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1520 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-7348
Mailing Address - Country:US
Mailing Address - Phone:336-838-7111
Mailing Address - Fax:336-838-4299
Practice Address - Street 1:1520 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-7348
Practice Address - Country:US
Practice Address - Phone:336-838-7111
Practice Address - Fax:336-838-4299
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC357482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8975113Medicaid
E66576Medicare UPIN
NC2173867Medicare ID - Type Unspecified