Provider Demographics
NPI:1285623694
Name:NEGRON, DAVID (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:NEGRON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:NEGRON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:2 RAGON LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-3155
Mailing Address - Country:US
Mailing Address - Phone:631-338-9677
Mailing Address - Fax:
Practice Address - Street 1:101 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-560-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC717213ES0131X
MA2392213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110096050AMedicaid
NYP92371Medicare UPIN
NY4441290001Medicare NSC
MA110096050AMedicaid
NY4441290001Medicare NSC