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General NPI Number Information
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NPI Number | 1215321419
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Entity Type | Individual
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Provider Name | MARSHALL ALEXANDER AHEARN MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 4420 LAKE BOONE TRL
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City | RALEIGH
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State | NC
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Zip | 27607-7505
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Country | US
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Telephone | 704-451-7314
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Fax |
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Provider Business Mailing Address
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Address Line | 231 MACNIDER HALL CB 7225
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City | CHAPEL HILL
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State | NC
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Zip | 27599-7225
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Country | US
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Telephone | 704-451-7314
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | DR.0060280
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | DR.0060280
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2019-02861
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License Number State | NC
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