Healthcare Provider Details

I. General information

NPI: 1962477752
Provider Name (Legal Business Name): DAVID C. CARRINGTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MORRIS ST SUITE 105
CHARLESTON WV
25301-1842
US

IV. Provider business mailing address

415 MORRIS ST 300
CHARLESTON WV
25301-1853
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-8199
  • Fax: 304-388-8195
Mailing address:
  • Phone: 304-388-6441
  • Fax: 304-388-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberDR.0067382
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number25064
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number25064
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number91350
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: