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NPI Code Detail

MEDICARE: MR. DENNIS CLARK KABASAN MD

MEDICARE: MR. DENNIS CLARK KABASAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician25039NC
2207R00000XInternal Medicine Physician25039NC

General Provider Information

NPI Number : 1043279516
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS CLARK KABASAN MD
Provider Business Mailing Address
First Line : 571 S ALLEN RD
Second Line :
City : FLAT ROCK
State : NC
Zip : 28731-9447
Country : US
Telephone Number : 828-692-6178
Fax Number : 828-692-2365
Provider Business Practice Location Address
First Line : 571 S ALLEN RD
Second Line :
City : FLAT ROCK
State : NC
Zip : 28731-9447
Country : US
Telephone Number : 828-692-6178
Fax Number : 828-692-2365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 03/09/2020

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