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NPI Code Detail

MEDICARE: MR. DAVID FRANCIS MINOR P.A.-C

MEDICARE: MR. DAVID FRANCIS MINOR P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant101184NC
2363AM0700XMedical Physician Assistant101184NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1152UWOTHERNCBCBS

General Provider Information

NPI Number : 1578535696
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID FRANCIS MINOR P.A.-C
Provider Business Mailing Address
First Line : 3069 TRENWEST DR
Second Line : SUITE 200
City : WINSTON SALEM
State : NC
Zip : 27103-3211
Country : US
Telephone Number : 336-922-1102
Fax Number : 336-922-5012
Provider Business Practice Location Address
First Line : 3734 REYNOLDA RD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27106-2240
Country : US
Telephone Number : 336-922-1102
Fax Number : 336-922-5012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 12/01/2014

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