MEDICARE: CATAWBA PEDIATRIC ASSOCIATES, P.A.

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
1	208000000X	Pediatrics Physician	56950	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0135R	OTHER	NC	NC BCBS
2	56950	OTHER	NC	NC MEDICAL BOARD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447220389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATAWBA PEDIATRIC ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	108 DOCTORS PARK
Second Line	:
City	:	LINCOLNTON
State	:	NC
Zip	:	28092-4406
Country	:	US
Telephone Number	:	704-736-9244
Fax Number	:	704-736-9318

Provider Business Practice Location Address
First Line	:	108 DOCTORS PARK
Second Line	:
City	:	LINCOLNTON
State	:	NC
Zip	:	28092-4406
Country	:	US
Telephone Number	:	704-736-9244
Fax Number	:	704-736-9318

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	DEBORAH S CASHION
Credential	:
Telephone Number	:	828-624-3105

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	08/22/2020

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