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NPI Code Detail

MEDICARE: DAVID JAMES RATHVON PA-C

MEDICARE: DAVID JAMES RATHVON PA-C
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
1363AM0700XMedical Physician Assistant102517NC

General Provider Information

NPI Number : 1154366201
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID JAMES RATHVON PA-C
Provider Business Mailing Address
First Line : PO BOX 14006
Second Line :
City : RALEIGH
State : NC
Zip : 27620-4006
Country : US
Telephone Number : 919-231-3966
Fax Number : 919-231-3912
Provider Business Practice Location Address
First Line : 23 SUNNYBROOK RD
Second Line : SUITE 145
City : RALEIGH
State : NC
Zip : 27610-1855
Country : US
Telephone Number : 919-231-3966
Fax Number : 919-231-3912
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 07/09/2007

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Directions to “ DAVID JAMES RATHVON PA-C” Practice Location

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