Healthcare Provider Details

I. General information

NPI: 1265482723
Provider Name (Legal Business Name): ROBERT EDWARD BABER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 THOMPSON ST STE A
HENDERSONVILLE NC
28792-2895
US

IV. Provider business mailing address

1032 FLEMING ST CAROLINA MOUNTAIN GASTROENTEROLOGY
HENDERSONVILLE NC
28791
US

V. Phone/Fax

Practice location:
  • Phone: 828-697-3232
  • Fax: 828-698-0125
Mailing address:
  • Phone: 828-696-3099
  • Fax: 828-696-3868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number101099
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0101099
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: