Provider Demographics
NPI:1285816157
Name:ORDAZ VERNET, ENRIQUE JOSE (MD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:JOSE
Last Name:ORDAZ VERNET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28687-1845
Mailing Address - Country:US
Mailing Address - Phone:704-838-8240
Mailing Address - Fax:704-924-5360
Practice Address - Street 1:208 OLD MOCKSVILLE RD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-1953
Practice Address - Country:US
Practice Address - Phone:704-838-8240
Practice Address - Fax:704-924-5360
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2014-00848207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease