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NPI Code Detail

MEDICARE: JOHN MERSHON PA-C

MEDICARE: JOHN MERSHON 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 Assistant0010-12014NC

General Provider Information

NPI Number : 1639541444
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MERSHON PA-C
Provider Business Mailing Address
First Line : 210 TOWNE VILLAGE DR
Second Line :
City : CARY
State : NC
Zip : 27513-8910
Country : US
Telephone Number : 919-859-3373
Fax Number :
Provider Business Practice Location Address
First Line : 3405 NW FEDERAL HWY
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-4439
Country : US
Telephone Number : 772-692-8082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2015
Last Update Date : 05/08/2024

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