Healthcare Provider Details

I. General information

NPI: 1477748747
Provider Name (Legal Business Name): DAVID B DURHAM MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 HUFFMAN MILL RD SUITE 2450
BURLINGTON NC
27215-8700
US

IV. Provider business mailing address

1236 HUFFMAN MILL RD SUITE 2450
BURLINGTON NC
27215-8700
US

V. Phone/Fax

Practice location:
  • Phone: 336-586-1925
  • Fax: 336-586-1931
Mailing address:
  • Phone: 336-586-1925
  • Fax: 336-586-1931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: DR. DAVID B DURHAM
Title or Position: CEO
Credential: MD
Phone: 336-586-1925