Organization
DOUGLAS DUSSEL PRITCHARD MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS DUSSEL PRITCHARD M.D. (OWNER)
(704) 818-0840
Entity
Organization
Contact information
Practice address
610 SIGNAL HILL DRIVE EXT, SUITE 100, STATESVILLE, NC 28625-4337
(704) 818-0480
(704) 818-0490
Mailing address
610 SIGNAL HILL DRIVE EXT, SUITE 100, STATESVILLE, NC 28625-4337
(704) 818-0480
(704) 818-0490
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
18045
NC
261QP3300X
Pain Clinic/Center
Primary
10845
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132YC
BCBS
NC
01
—
196255
MEDCOST
NC
01
—
209727A
MEDICARE INDIVIDUAL PTAN
NC
01
—
7870927
AETNA
NC
01
—
DG1403
RR MEDICARE
NC
Enumeration date
02/16/2007
Last updated
10/27/2016
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