MEDICARE: MARK ALBERT PASHAYAN 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
1	208000000X	Pediatrics Physician	95-01046	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	:	1114919321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ALBERT PASHAYAN MD

Provider Business Mailing Address
First Line	:	PO BOX 602658
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2658
Country	:	US
Telephone Number	:	336-716-2011
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 LEWISVILLE CLEMMONS RD
Second Line	:
City	:	CLEMMONS
State	:	NC
Zip	:	27012-8905
Country	:	US
Telephone Number	:	336-713-0582
Fax Number	:	336-713-0581

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	01/10/2017

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Directions to “ MARK ALBERT PASHAYAN MD” Practice Location

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