Individual
DAVID DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9900477
NC
208000000X
Pediatrics Physician
Primary
E-12032
AR
2080P0207X
Pediatric Hematology & Oncology Physician
E-12032
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1216X
BCBS
NC
01
—
23702
WELLPATH
NC
01
—
31605
PARTNERS MEDICARE CHOICE
NC
01
—
562034548
GROUP TAX ID
NC
01
—
7428011
AETNA
NC
01
—
88655
MEDCOST
NC
05
—
891216X
—
NC
01
—
895159
MAMSI
NC
Enumeration date
02/28/2006
Last updated
03/28/2023
Update your record
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