MEDICARE: DR. SHONDA MICHELLE ASAAD 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	207RH0003X	Hematology & Oncology Physician	26720	SC
2	207RH0003X	Hematology & Oncology Physician	2010-00129	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01121033	OTHER	NC	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7040266	OTHER	NC	CIGNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7090521	OTHER	NC	AETNA

General Provider Information

NPI Number	:	1831122035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHONDA MICHELLE ASAAD M.D.

Provider Business Mailing Address
First Line	:	239 STATION STREET
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546
Country	:	US
Telephone Number	:	910-353-0819
Fax Number	:	910-353-0828

Provider Business Practice Location Address
First Line	:	239 STATION ST
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-6304
Country	:	US
Telephone Number	:	910-353-0819
Fax Number	:	910-353-0828

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/21/2022

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Directions to “ DR. SHONDA MICHELLE ASAAD M.D.” Practice Location

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