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General NPI Number Information
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NPI Number | 1700922937
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Entity Type | Organization
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Legal Business Name | ANSON FAMILY MEDICINE, PC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 12/29/2008
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Provider Practice Location Address
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Address Line | 510 MORVEN RD
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City | WADESBORO
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State | NC
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Zip | 28170-2745
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Country | US
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Telephone | 704-694-9440
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Fax | 704-694-9440
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Provider Business Mailing Address
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Address Line | 510 MORVEN RD
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City | WADESBORO
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State | NC
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Zip | 28170-2745
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Country | US
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Telephone | 704-694-9440
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Fax | 704-694-9440
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Authorized Official
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Title or Position | PHYSICIAN
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Name | VICTORIA ROMMEL
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Credential | M.D.
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Telephone | 704-694-9440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35041
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License Number State | NC
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