Healthcare Provider Details

I. General information

NPI: 1568423283
Provider Name (Legal Business Name): DAVID P MASON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 GLEN MEADE RD
WILMINGTON NC
28403-6022
US

IV. Provider business mailing address

PO BOX 602484
CHARLOTTE NC
28260-2484
US

V. Phone/Fax

Practice location:
  • Phone: 910-763-9833
  • Fax: 910-763-5166
Mailing address:
  • Phone: 910-763-9833
  • Fax: 910-763-5166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20820
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: