MEDICARE: DAVID KING MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	33388	NC

General Provider Information

NPI Number	:	1518953017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID KING MD

Provider Business Mailing Address
First Line	:	948 N MAIN ST
Second Line	:
City	:	LOUISBURG
State	:	NC
Zip	:	27549-2149
Country	:	US
Telephone Number	:	919-496-3375
Fax Number	:	919-496-5669

Provider Business Practice Location Address
First Line	:	948 N MAIN ST
Second Line	:
City	:	LOUISBURG
State	:	NC
Zip	:	27549-2149
Country	:	US
Telephone Number	:	919-496-3375
Fax Number	:	919-496-5669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	07/08/2007

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