Provider Demographics
NPI:1972549301
Name:DURALIA, DAVID R (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:DURALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2874 NC HWY 127 S
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-9130
Mailing Address - Country:US
Mailing Address - Phone:828-294-4100
Mailing Address - Fax:828-294-4112
Practice Address - Street 1:2874 NC HWY 127 S
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9130
Practice Address - Country:US
Practice Address - Phone:828-294-4100
Practice Address - Fax:828-294-4112
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200679207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0238GOtherBCBS GR
NC132M9OtherBCBS
NC132M9OtherBCBS INDIV
NC89132M9Medicaid
NC890238GOtherMEDICAID GROUP
NC2335809OtherMEDICARE GROUP
NC2342928OtherMEDICARE GROUP
NC890238GMedicaid
NC0238GOtherBCBS GROUP
NC132M9OtherBCBS
NC2006547AMedicare ID - Type Unspecified
NC0238GOtherBCBS GR
NC2335809OtherMEDICARE GROUP
H73403Medicare UPIN