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General NPI Number Information
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NPI Number | 1699760959
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Entity Type | Individual
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Provider Name | ALFRED DOUGLAS EARWOOD MD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 150 PARK AVE
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City | BANNER ELK
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State | NC
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Zip | 28604-6604
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Country | US
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Telephone | 828-898-5177
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Fax | 828-898-8306
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Provider Business Mailing Address
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Address Line | PO BOX 1568
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City | BANNER ELK
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State | NC
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Zip | 28604-1568
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Country | US
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Telephone | 828-898-5177
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Fax | 828-898-8306
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33815
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License Number State | NC
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