MEDICARE: JENNIFER NATASHSA DAVID D.O.

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	207N00000X	Dermatology Physician	2023-03179	NC

General Provider Information

NPI Number	:	1740571496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NATASHSA DAVID D.O.

Provider Business Mailing Address
First Line	:	1200 N ELM ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3518 DRAWBRIDGE PKWY STE 320
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8432
Country	:	US
Telephone Number	:	336-890-2210
Fax Number	:	336-890-2211

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

Provider Enumeration Date	:	04/28/2011
Last Update Date	:	02/28/2024

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