Healthcare Provider Details

I. General information

NPI: 1073768461
Provider Name (Legal Business Name): WESTERN SURGICAL CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2008
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 LIVINGSTON ST SUITE 300
ASHEVILLE NC
28801
US

IV. Provider business mailing address

60 LIVINGSTON ST SUITE 300
ASHEVILLE NC
28801
US

V. Phone/Fax

Practice location:
  • Phone: 828-258-2464
  • Fax: 828-255-8224
Mailing address:
  • Phone: 828-258-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number14543
License Number StateNC

VIII. Authorized Official

Name: DR. ROBERT C MOFFATT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 828-258-2464