MEDICARE: ELLEN CALHOUN AESCHLEMAN PA

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	363AM0700X	Medical Physician Assistant	0010-00588	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0010-00588	OTHER	NC	NC MEDICAL BOARD

General Provider Information

NPI Number	:	1477749935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN CALHOUN AESCHLEMAN PA

Provider Business Mailing Address
First Line	:	4355 HICKORY BLVD
Second Line	:	LOWER SUITE
City	:	GRANITE FALLS
State	:	NC
Zip	:	28630-1992
Country	:	US
Telephone Number	:	828-757-5056
Fax Number	:	858-757-5051

Provider Business Practice Location Address
First Line	:	4355 HICKORY BLVD
Second Line	:	LOWER SUITE
City	:	GRANITE FALLS
State	:	NC
Zip	:	28630-1992
Country	:	US
Telephone Number	:	828-757-5056
Fax Number	:	858-757-5051

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

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	03/07/2023

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