Healthcare Provider Details

I. General information

NPI: 1154416519
Provider Name (Legal Business Name): LISA VERGES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 SOUTHSIDE AVE STE 350
ASHEVILLE NC
28801
US

IV. Provider business mailing address

185 BRUNSWICK RD
WAYNESVILLE NC
28786-4778
US

V. Phone/Fax

Practice location:
  • Phone: 954-377-3094
  • Fax:
Mailing address:
  • Phone: 828-246-7384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35066
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number35066
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35066
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: