Healthcare Provider Details

I. General information

NPI: 1871558817
Provider Name (Legal Business Name): DAVID A DALESSIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR STE 4300
DURHAM NC
27710-0001
US

IV. Provider business mailing address

758 OLD MILL RD
CHAPEL HILL NC
27514-3927
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-5778
  • Fax: 919-681-8477
Mailing address:
  • Phone: 513-475-7400
  • Fax: 513-475-7410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-077498
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35-077498
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number2014-00858
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2014-00858
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: