Provider Demographics
NPI:1306891429
Name:CUTRELL, DARRIN GREGORY (PA-C)
Entity type:Individual
Prefix:MR
First Name:DARRIN
Middle Name:GREGORY
Last Name:CUTRELL
Suffix:
Gender:M
Credentials:PA-C
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 3000
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-3000
Mailing Address - Country:US
Mailing Address - Phone:910-715-2164
Mailing Address - Fax:910-715-4493
Practice Address - Street 1:155 MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8710
Practice Address - Country:US
Practice Address - Phone:910-715-2164
Practice Address - Fax:910-715-1247
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000102905363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S94668Medicare UPIN
NC2752643EMedicare ID - Type Unspecified