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General NPI Number Information
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NPI Number | 1184680522
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Entity Type | Individual
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Provider Name | NAILESH D DAVE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 04/26/2011
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Provider Practice Location Address
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Address Line | 350 PINE STATE ST
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City | LILLINGTON
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State | NC
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Zip | 27546-9428
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Country | US
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Telephone | 910-893-9700
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Fax | 910-893-9747
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Provider Business Mailing Address
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Address Line | 350 PINE STATE STREET
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City | LILLINGTON
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State | NC
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Zip | 27546-7961
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Country | US
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Telephone | 910-893-9700
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Fax | 910-893-9747
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 9900027
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License Number State | NC
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