Healthcare Provider Details

I. General information

NPI: 1851131155
Provider Name (Legal Business Name): NICHOLAS MADAMA-BAUMGAERTEL PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NICHOLAS BAUMGAERTEL

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
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

Practice location:
  • Phone: 828-258-1121
  • Fax: 828-252-6114
Mailing address:
  • Phone: 828-258-1121
  • Fax: 828-252-6114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16067
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0010-16067
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: