Individual
DAVID WILBUR LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
496 ALTAPASS HWY, SPRUCE PINE, NC 28777
(828) 765-0170
(828) 765-5877
Mailing address
496 ALTAPASS HWY, SPRUCE PINE, NC 28777
(828) 765-0170
(828) 765-5877
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18534
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00513
BLUE CROSS
NC
01
—
0081P
BCBS SWINGBED
NC
01
—
014MX
BLUE CROSS LABS
NC
01
—
07673
BLUE CROSS PHYSICIAN
NC
01
—
201464G
MEDICARE PHYSICIAN
NC
01
—
34U011
MEDICARE SWINGBED
NC
01
—
51049
BCBS INDIVIDUAL PROVIDER
NC
01
—
8951049
MEDICAID
NC
Enumeration date
06/27/2006
Last updated
01/15/2008
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