Healthcare Provider Details

I. General information

NPI: 1437374584
Provider Name (Legal Business Name): DAVID VANMATER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DUKE UNIVERSITY MEDICAL CENTER 2301 ERWIN ROAD
DURHAM NC
27710
US

IV. Provider business mailing address

DUMC BOX 102382, ROOM 382 HANES HOUSE 330 TRENT DRIVE
DURHAM NC
27710
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-3401
  • Fax:
Mailing address:
  • Phone: 919-684-3401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2009-01222
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number2009-01222
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: