Healthcare Provider Details

I. General information

NPI: 1285722801
Provider Name (Legal Business Name): MOUNTAIN AREA FAMILY MEDICINE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 WHITE OWL LANE
CASHIERS NC
28717-0000
US

IV. Provider business mailing address

PO BOX 1828
CASHIERS NC
28717-1828
US

V. Phone/Fax

Practice location:
  • Phone: 828-743-2491
  • Fax: 828-743-3060
Mailing address:
  • Phone: 828-743-2491
  • Fax: 828-743-3060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number63833
License Number StateNC

VIII. Authorized Official

Name: DR. DAVID WHEELER
Title or Position: SECRETARY
Credential: MD
Phone: 828-743-2491