Provider Demographics
NPI:1982795407
Name:BILLUE, DAVID CLAYTON (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CLAYTON
Last Name:BILLUE
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 1:288 S RIDGECREST AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-2838
Mailing Address - Country:US
Mailing Address - Phone:828-286-5583
Mailing Address - Fax:828-286-5584
Practice Address - Street 1:288 S RIDGECREST AVE STE 1
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2838
Practice Address - Country:US
Practice Address - Phone:828-286-5583
Practice Address - Fax:828-286-5584
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00078207V00000X
SC36475207V00000X
TXP6338207V00000X
AL13710207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3324691-01Medicaid
AL000018834Medicaid
AL000018834Medicaid
A98750Medicare UPIN