Healthcare Provider Details

I. General information

NPI: 1144686924
Provider Name (Legal Business Name): DAVID BIERMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 OAK HILL LOOP
CARY NC
27513-2417
US

IV. Provider business mailing address

122 OAK HILL LOOP
CARY NC
27513-2417
US

V. Phone/Fax

Practice location:
  • Phone: 919-677-0031
  • Fax:
Mailing address:
  • Phone: 919-677-0031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number30600
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD60672211
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: