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NPI Code Detail

MEDICARE: MELINDA RUTH ASFAW PA-C

MEDICARE: MELINDA RUTH ASFAW 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
1363A00000XPhysician AssistantPA30190DC
2363A00000XPhysician Assistant0010-01306NC

General Provider Information

NPI Number : 1568524023
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELINDA RUTH ASFAW PA-C
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-316-5070
Fax Number : 704-316-5075
Provider Business Practice Location Address
First Line : 9604 HOLLY POINT DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-4913
Country : US
Telephone Number : 704-316-5070
Fax Number : 704-316-5075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 10/25/2020

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Directions to “ MELINDA RUTH ASFAW PA-C” Practice Location

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