Provider Demographics
NPI:1528335239
Name:CLOUD, DAVID A (CPED)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:CLOUD
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 OWEN DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3414
Mailing Address - Country:US
Mailing Address - Phone:910-323-9016
Mailing Address - Fax:910-486-8712
Practice Address - Street 1:234 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3414
Practice Address - Country:US
Practice Address - Phone:910-323-9016
Practice Address - Fax:910-486-8712
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0478VOtherBCBS
NC7701177Medicaid
NC0535700001Medicare NSC