Healthcare Provider Details

I. General information

NPI: 1093086993
Provider Name (Legal Business Name): RADIATION THERAPY ASSOCIATES OF WESTERN NORTH CAROLINA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2012
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL PARK DR
ASHEVILLE NC
28803-2493
US

IV. Provider business mailing address

2234 COLONIAL BLVD
FORT MYERS FL
33907-1412
US

V. Phone/Fax

Practice location:
  • Phone: 828-254-8232
  • Fax:
Mailing address:
  • Phone: 239-931-7342
  • Fax: 239-931-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY D. SHAFMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 401-456-2690