Provider Demographics
NPI:1538197934
Name:BOYD, DALE WOODS JR (MD)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:WOODS
Last Name:BOYD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6019 OLEANDER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4796
Mailing Address - Country:US
Mailing Address - Phone:910-790-9714
Mailing Address - Fax:910-791-1063
Practice Address - Street 1:6019 OLEANDER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4796
Practice Address - Country:US
Practice Address - Phone:910-790-9714
Practice Address - Fax:910-791-1063
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2009-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC35845207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC17205OtherBCBS
NC8917205Medicaid
NCE99597Medicare UPIN
NC2330020Medicare ID - Type Unspecified