Provider Demographics
NPI:1295846525
Name:RICE, MONA VENZON (MD)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:VENZON
Last Name:RICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 BEAR PAW LN STE 101
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9150
Mailing Address - Country:US
Mailing Address - Phone:828-458-0097
Mailing Address - Fax:828-575-5448
Practice Address - Street 1:100 DISTRICT DR APT 218
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-0232
Practice Address - Country:US
Practice Address - Phone:828-774-5068
Practice Address - Fax:828-575-5448
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA934222084P0800X
NC2005-014752084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5919832Medicaid