Organization
DARE MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER L HOLTON MD (OWNER)
(252) 473-3478
Entity
Organization
Contact information
Practice address
604 AMANDA ST, MANTEO, NC 27954
(252) 473-3478
(252) 473-3600
Mailing address
PO BOX 1045, MANTEO, NC 27954-1045
(252) 473-3478
(252) 473-3600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19609
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01408
BCBS
NC
05
—
8901408
—
NC
Enumeration date
03/22/2006
Last updated
04/20/2008
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