Basic Information
| Provider Information | |||||||||
| NPI: | 1639161862 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAPPENFIELD | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4102 N ROXBORO ST | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277042122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9195952000 | ||||||||
| FaxNumber: | 9195952190 | ||||||||
| Practice Location | |||||||||
| Address1: | 4102 N ROXBORO ST | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277042122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9195952000 | ||||||||
| FaxNumber: | 9195952190 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 04/01/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 29505 | NC | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0107X | 29505 | NC | Y |
ID Information
| ID | Type | State | Issuer | Description | 4454143 | 01 | NC | AETNA | OTHER | 8974496 | 05 | NC | MEDICAID | 0851810 | 01 | NC | UNITED HEALTHCARE | OTHER | 561288767Q | 01 | NC | CIGNA | OTHER | 74496 | 01 | NC | BCBS NC | OTHER | 41892 | 01 | NC | MEDCOST | OTHER | 19536 | 01 | NC | OPTICARE | OTHER | 230207 | 01 | NC | MAMSI | OTHER |