Healthcare Provider Details

I. General information

NPI: 1720493430
Provider Name (Legal Business Name): ERIN RENEE POARCH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN RENEE WOJCIESZYN

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 06/10/2020
Certification Date: 06/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N FAYETTEVILLE ST
ASHEBORO NC
27203-4728
US

IV. Provider business mailing address

218 FOUST ST STE C
ASHEBORO NC
27203-5476
US

V. Phone/Fax

Practice location:
  • Phone: 336-626-2688
  • Fax: 336-626-4100
Mailing address:
  • Phone: 336-625-2333
  • Fax: 336-625-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-06458
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC5-0000948
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: