Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 15847 | NC |
NPI | 1306847660 |
---|---|
Provider Name | David Maurice Hurst |
First Address | Greensboro, NC 27407-1301 |
Second Address | Greensboro, NC 27407-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8945085 | (05) | NC |
C84654 | (02) |