Healthcare Provider Details

I. General information

NPI: 1588866362
Provider Name (Legal Business Name): DAVID SPENCER CARNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 OLEANDER DRIVE
WILMINGTON NC
28403-7018
US

IV. Provider business mailing address

5115 OLEANDER DRIVE
WILMINGTON NC
28403-7018
US

V. Phone/Fax

Practice location:
  • Phone: 910-362-1011
  • Fax: 910-362-1012
Mailing address:
  • Phone: 910-362-1011
  • Fax: 910-362-1012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200800506
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number200800506
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: