Healthcare Provider Details

I. General information

NPI: 1023700655
Provider Name (Legal Business Name): RONALD NORMAN HIJDUK JR. PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 QUIET CV
FAYETTEVILLE NC
28304-3857
US

IV. Provider business mailing address

1880 QUIET CV
FAYETTEVILLE NC
28304-3857
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-2477
  • Fax: 910-323-5931
Mailing address:
  • Phone: 910-323-2477
  • Fax: 910-323-5931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-13381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: