Provider Demographics
NPI:1871693648
Name:PEARSON, DARRYL HECTOR (MD)
Entity type:Individual
Prefix:
First Name:DARRYL
Middle Name:HECTOR
Last Name:PEARSON
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 1:991 WEST HUDSON BLVD.
Mailing Address - Street 2:GASTON COUNTY HEALTH DEPARTMENT
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052
Mailing Address - Country:US
Mailing Address - Phone:704-853-5000
Mailing Address - Fax:
Practice Address - Street 1:991 WEST HUDSON BLVD.
Practice Address - Street 2:GASTON COUNTY HEALTH DEPARTMENT
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052
Practice Address - Country:US
Practice Address - Phone:704-853-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32026207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA29989OtherGEORGIA LICENSURE #
NC66445OtherBCBS NUMBER
NC8966445Medicaid
NC32026OtherNC LICENSURE #
AL13884OtherALABAMA LICENSURE #
AL13884OtherALABAMA LICENSURE #
BP2236481OtherDEA NUMBER
GA29989OtherGEORGIA LICENSURE #