Individual
DARRYL SANDIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1260 N ARENDELL AVE, ZEBULON, NC 27597-8730
(919) 235-1965
(919) 235-1326
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-8991
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
0010-06204
NC
363A00000X
Physician Assistant
Primary
0010-06204
NC
363A00000X
Physician Assistant
PA9102240
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-06204
NC MEDICAL BOARD
NC
Enumeration date
04/04/2006
Last updated
10/27/2022
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