Healthcare Provider Details

I. General information

NPI: 1790785798
Provider Name (Legal Business Name): DAVID LEE ABERNETHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 FAIRWAY SHOPPING CTR
HUDSON NC
28638-2440
US

IV. Provider business mailing address

PO BOX 794
HUDSON NC
28638-0794
US

V. Phone/Fax

Practice location:
  • Phone: 828-754-8482
  • Fax: 828-754-4456
Mailing address:
  • Phone: 828-754-8482
  • Fax: 828-754-4456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20865
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: