Provider Demographics
NPI:1235532888
Name:SUPERIOR HEALTH PHYSICAL MEDICINE OF ASHEVILLE, PC
Entity Type:Organization
Organization Name:SUPERIOR HEALTH PHYSICAL MEDICINE OF ASHEVILLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:CCS-P
Authorized Official - Phone:814-312-1199
Mailing Address - Street 1:38 WESTGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-3808
Mailing Address - Country:US
Mailing Address - Phone:828-575-6244
Mailing Address - Fax:
Practice Address - Street 1:38 WESTGATE PKWY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806
Practice Address - Country:UM
Practice Address - Phone:828-595-4886
Practice Address - Fax:828-595-4891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-26
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty