Healthcare Provider Details

I. General information

NPI: 1073564100
Provider Name (Legal Business Name): STEVEN ROSS SALDUTTI PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 01/07/2022
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 MEDICAL PARK DR
BREVARD NC
28712-4189
US

IV. Provider business mailing address

1409 ASHEVILLE HWY
BREVARD NC
28712-9524
US

V. Phone/Fax

Practice location:
  • Phone: 828-884-9362
  • Fax: 828-884-3851
Mailing address:
  • Phone: 828-435-8400
  • Fax: 828-435-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number104019
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number104019
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: