MEDICARE: DR. DAVID JOSEPH AHLBERG 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	2084P0800X	Psychiatry Physician	200500147	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679519706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOSEPH AHLBERG MD

Provider Business Mailing Address
First Line	:	PO BOX 12459
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-2459
Country	:	US
Telephone Number	:	910-939-0724
Fax Number	:	910-333-9145

Provider Business Practice Location Address
First Line	:	39 OFFICE PARK DR STE A
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-3220
Country	:	US
Telephone Number	:	910-939-0724
Fax Number	:	910-333-9145

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

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	03/02/2023

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