Provider Demographics
NPI:1093403727
Name:PISGAH DIRECT PRIMARY CARE, PLLC
Entity Type:Organization
Organization Name:PISGAH DIRECT PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BC-FNP, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-313-4571
Mailing Address - Street 1:102 CRANBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9603
Mailing Address - Country:US
Mailing Address - Phone:941-313-4571
Mailing Address - Fax:828-662-2004
Practice Address - Street 1:102 CRANBROOK DR
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-9603
Practice Address - Country:US
Practice Address - Phone:941-313-4571
Practice Address - Fax:828-662-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty