Healthcare Provider Details

I. General information

NPI: 1073574190
Provider Name (Legal Business Name): PEDIATRIC PULMONOLOGY AND SLEEP DISORDERS OF WNC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MCDOWELL ST SUITE 203
ASHEVILLE NC
28801-4453
US

IV. Provider business mailing address

PO BOX 15268
ASHEVILLE NC
28813-0268
US

V. Phone/Fax

Practice location:
  • Phone: 828-258-7060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN CLARKE MCINTOSH
Title or Position: OWNER
Credential: M.D.
Phone: 828-258-7060