Healthcare Provider Details

I. General information

NPI: 1043215726
Provider Name (Legal Business Name): MELINDA SUE DARLING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N POINTE BLVD
MOUNT AIRY NC
27030-2266
US

IV. Provider business mailing address

PO BOX 1267
MOUNT AIRY NC
27030-1267
US

V. Phone/Fax

Practice location:
  • Phone: 336-789-6267
  • Fax: 336-786-4245
Mailing address:
  • Phone: 336-786-4522
  • Fax: 336-789-3025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9701308
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier77972
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerSTATE LICENSE
# 2
Identifier891087C
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 3
IdentifierMD458874
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerSTATE LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: