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NPI Code Detail

MEDICARE: MRS. PHEBE ANN DAGROSA PA-C

MEDICARE: MRS. PHEBE ANN DAGROSA PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant0010-05971NC
2363A00000XPhysician Assistant0010-05971NC

General Provider Information

NPI Number : 1386013662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PHEBE ANN DAGROSA PA-C
Provider Business Mailing Address
First Line : 5901 PEACHTREE DUNWOODY RD # 350
Second Line :
City : ATLANTA
State : GA
Zip : 30328-5382
Country : US
Telephone Number : 678-441-8500
Fax Number :
Provider Business Practice Location Address
First Line : 2460 CURTIS ELLIS DR
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-2237
Country : US
Telephone Number : 828-456-7311
Fax Number : 252-962-3320
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2015
Last Update Date : 12/10/2025

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