MEDICARE: DAVID CORBETT DO

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	174400000X	Specialist		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	128E0 BCBS	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740284272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CORBETT DO

Provider Business Mailing Address
First Line	:	2874 WARD BLVD
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-1761
Country	:	US
Telephone Number	:	252-291-5600
Fax Number	:	252-291-6935

Provider Business Practice Location Address
First Line	:	2874 WARD BLVD
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-1761
Country	:	US
Telephone Number	:	252-291-5600
Fax Number	:	252-291-6935

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	09/25/2007

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Directions to “ DAVID CORBETT DO” Practice Location

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