Healthcare Provider Details
I. General information
NPI: 1376690412
Provider Name (Legal Business Name): ASHEVILLE HEART PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2007
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
257 MCDOWELL ST
ASHEVILLE NC
28803-2606
US
IV. Provider business mailing address
257 MCDOWELL ST
ASHEVILLE NC
28803-2606
US
V. Phone/Fax
- Phone: 828-258-1121
- Fax: 828-252-6114
- Phone: 828-258-1121
- Fax: 828-252-6114
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
CATHY
J
WILES
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 828-258-1121