Healthcare Provider Details

I. General information

NPI: 1477530848
Provider Name (Legal Business Name): DAVID ARTHUR DALSIMER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 DAWN DR SUITE 2300
LUMBERTON NC
28360-8287
US

IV. Provider business mailing address

2600 N ELM ST
LUMBERTON NC
28358-3011
US

V. Phone/Fax

Practice location:
  • Phone: 910-738-1065
  • Fax: 910-738-5143
Mailing address:
  • Phone: 910-671-5367
  • Fax: 910-738-3764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number02439
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number200501603
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: