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General NPI Number Information
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NPI Number | 1346749074
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Entity Type | Individual
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Provider Name | JOHN FRANCIS AUGUSTIN DER GHAZARIAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 90 GUARDIAN CT
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-3017
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Country | US
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Telephone | 252-210-9015
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Fax | 252-632-0242
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Provider Business Mailing Address
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Address Line | 90 GUARDIAN CT
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-3017
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Country | US
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Telephone | 252-210-9015
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Fax | 252-632-0242
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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 | 0010-12430
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License Number State | NC
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