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General NPI Number Information
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NPI Number | 1174687271
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Entity Type | Individual
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Provider Name | MARY E TOLLE P.A.
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Gender | Female
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 51 MOSAIC BLVD STE 100
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City | PITTSBORO
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State | NC
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Zip | 27312-4945
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Country | US
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Telephone | 984-215-6766
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Fax | 984-215-6768
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Provider Business Mailing Address
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Address Line | 5221 PARAMOUNT PKWY STE 220
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City | MORRISVILLE
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State | NC
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Zip | 27560-5490
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 103323
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 103323
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License Number State | NC
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