MEDICARE: MRS. MARY FRANCES VASSUAR SEARS PAC

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
1	363A00000X	Physician Assistant	0010-00277	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114080819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY FRANCES VASSUAR SEARS PAC

Provider Business Mailing Address
First Line	:	735 8TH AVE NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-3932
Country	:	US
Telephone Number	:	828-328-7958
Fax Number	:	828-732-5936

Provider Business Practice Location Address
First Line	:	735 8TH AVE NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-3932
Country	:	US
Telephone Number	:	828-328-7958
Fax Number	:	828-732-5936

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	06/18/2026

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