Provider Demographics
NPI:1043826696
Name:FIELDS, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FIELDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 NATIONAL HWY
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-2312
Mailing Address - Country:US
Mailing Address - Phone:336-754-1470
Mailing Address - Fax:336-652-3155
Practice Address - Street 1:1052 NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-2312
Practice Address - Country:US
Practice Address - Phone:336-754-1470
Practice Address - Fax:336-652-3155
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion