Healthcare Provider Details

I. General information

NPI: 1538183199
Provider Name (Legal Business Name): MARIANNE R PESTOFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 YORKSHIRE ST
ASHEVILLE NC
28803-2752
US

IV. Provider business mailing address

2 YORKSHIRE ST
ASHEVILLE NC
28803-2752
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-1050
  • Fax: 828-253-0457
Mailing address:
  • Phone: 828-252-1050
  • Fax: 828-253-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number9600831
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: