Provider Demographics
NPI:1104898212
Name:PEARCE, DAVID M (MPT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:PEARCE
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12830
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-2830
Mailing Address - Country:US
Mailing Address - Phone:252-636-9800
Mailing Address - Fax:252-636-9855
Practice Address - Street 1:2009 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-3470
Practice Address - Country:US
Practice Address - Phone:252-636-9800
Practice Address - Fax:252-636-9855
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7787174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211373Medicaid
NC0795QOtherBCBS
NC2503957Medicare ID - Type Unspecified