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NPI Code Detail

MEDICARE: NANCY J ASTLE MD

MEDICARE: NANCY J ASTLE MD
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
1207N00000XDermatology Physician9400198NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2070007019AOTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101056OTHERNCBCBS NC

General Provider Information

NPI Number : 1740286178
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY J ASTLE MD
Provider Business Mailing Address
First Line : 1072 X RAY DR STE B
Second Line :
City : GASTONIA
State : NC
Zip : 28054-7488
Country : US
Telephone Number : 704-671-1094
Fax Number : 704-671-1095
Provider Business Practice Location Address
First Line : 13539 REESE BLVD W STE B
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-7961
Country : US
Telephone Number : 704-892-4878
Fax Number : 704-892-7453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 03/28/2023

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