Healthcare Provider Details

I. General information

NPI: 1962629725
Provider Name (Legal Business Name): HIGHLANDS MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 HICKS RD
HIGHLANDS NC
28741-8506
US

IV. Provider business mailing address

1029 HICKS RD
HIGHLANDS NC
28741-8506
US

V. Phone/Fax

Practice location:
  • Phone: 828-526-4346
  • Fax: 828-526-2914
Mailing address:
  • Phone: 828-526-4346
  • Fax: 828-526-2914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberD26938
License Number StateNC

VIII. Authorized Official

Name: PATTI B WHEELER
Title or Position: OWNER
Credential: MD
Phone: 828-526-4346