Healthcare Provider Details

I. General information

NPI: 1528084290
Provider Name (Legal Business Name): WILLIAM GERALD VAASSEN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MEDICAL HEIGHTS DR
MORGANTON NC
28655-5197
US

IV. Provider business mailing address

103 MEDICAL HEIGHTS DR
MORGANTON NC
28655-5197
US

V. Phone/Fax

Practice location:
  • Phone: 828-437-4211
  • Fax: 828-437-1034
Mailing address:
  • Phone: 828-437-4211
  • Fax: 828-437-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number100045
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: