MEDICARE: DR. PHILIP ASENSO M.D.

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	208M00000X	Hospitalist Physician	2009-01408	NC
2	207R00000X	Internal Medicine Physician	2009-01408	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1533F	OTHER	NC	NC BLUE CROSS/BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366673048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP ASENSO M.D.

Provider Business Mailing Address
First Line	:	5009 BENNINGTON WAY
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-8473
Country	:	US
Telephone Number	:	336-905-7174
Fax Number	:	844-522-8775

Provider Business Practice Location Address
First Line	:	1320 N HAMILTON ST
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-2600
Country	:	US
Telephone Number	:	336-905-7174
Fax Number	:	844-522-8775

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

Provider Enumeration Date	:	07/29/2009
Last Update Date	:	07/10/2024

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