Healthcare Provider Details

I. General information

NPI: 1619311305
Provider Name (Legal Business Name): DAVID LYNN LEVERENZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR
DURHAM NC
27710-0011
US

IV. Provider business mailing address

40 DUKE MEDICINE CIRCLE DRIVE BOX 2918
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-613-2243
  • Fax: 919-576-8820
Mailing address:
  • Phone: 919-613-2243
  • Fax: 919-576-8820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2017-01147
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2017-01147
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: