1427697622 NPI number — MR. DAVID DURANT DINSMORE CRNA

Table of content: MR. DAVID DURANT DINSMORE CRNA (NPI 1427697622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427697622 NPI number — MR. DAVID DURANT DINSMORE CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DINSMORE
Provider First Name:
DAVID
Provider Middle Name:
DURANT
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427697622
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14310 GREEN BIRCH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PINEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28134-9040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-358-0900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ATRIUM HEALTH PINEVILLE
Provider Second Line Business Practice Location Address:
10628 PARK ROAD
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-667-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  128642 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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