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General NPI Number Information
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NPI Number | 1104148386
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Entity Type | Individual
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Provider Name | DAVID MCCOY GINN PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 12/30/2016
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Provider Practice Location Address
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Address Line | 1401 N MEMORIAL DR
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City | GREENVILLE
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State | NC
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Zip | 27834-1278
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Country | US
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Telephone | 252-378-5862
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 N MEMORIAL DR
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City | GREENVILLE
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State | NC
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Zip | 27834-1278
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Country | US
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Telephone | 252-378-5862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-06922
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 006429
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1644
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License Number State | NV
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