Individual
DARIUS JOSE AYALA DIVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1501 N BICKETT BLVD STE E, LOUISBURG, NC 27549-2178
(919) 497-8380
(919) 497-8385
Mailing address
1501 N BICKETT BLVD STE E, LOUISBURG, NC 27549-2178
(919) 497-8380
(919) 497-8385
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
1135
SC
207X00000X
Orthopaedic Surgery Physician
Primary
2018-02770
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011356
—
SC
05
—
1366544843
—
NC
01
—
3255
MEDICARE PTAN FOR ABBEVILLE OFFICE
SC
Enumeration date
09/04/2006
Last updated
09/22/2022
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