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1578566592

NPI Code Detail

MEDICARE: DR. DONALD A DEWHURST II MD

MEDICARE: DR. DONALD A DEWHURST II MD

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
1	207Q00000X	Family Medicine Physician	20121	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1017H	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1017H	OTHER	NC	DR DEWHURST'S BCBS OF NC

General Provider Information

NPI Number	:	1578566592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD A DEWHURST II MD

Provider Business Mailing Address
First Line	:	1830 LAKESIDE DR
Second Line	:
City	:	FRANKLIN
State	:	NC
Zip	:	28734-6778
Country	:	US
Telephone Number	:	828-349-2081
Fax Number	:	828-524-6154

Provider Business Practice Location Address
First Line	:	1830 LAKESIDE DR
Second Line	:
City	:	FRANKLIN
State	:	NC
Zip	:	28734-6778
Country	:	US
Telephone Number	:	828-349-2081
Fax Number	:	828-524-6154

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/09/2016

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Directions to “ DR. DONALD A DEWHURST II MD” Practice Location

Language	Start Address	Practice Location

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