Healthcare Provider Details
I. General information
NPI: 1821082280
Provider Name (Legal Business Name): FAITH DEVINE DAGGS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/31/2005
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2909 MAPLEWOOD AVE
WINSTON SALEM NC
27103-4009
US
IV. Provider business mailing address
PO BOX 60447
CHARLOTTE NC
28260-0447
US
V. Phone/Fax
- Phone: 336-277-0340
- Fax: 336-794-9411
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 2018-00583 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 89157 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: