Healthcare Provider Details

I. General information

NPI: 1598693319
Provider Name (Legal Business Name): DAVID ADAM UELAND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2864 WOODRUFF STREET
FORT BRAGG NC
28310-0001
US

IV. Provider business mailing address

2555 CASTLEBAR DR APT 102
FAYETTEVILLE NC
28311-1588
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-0681
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberP511393
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: