Provider Demographics
NPI:1326008681
Name:ASHE INTERNAL MEDICINE PA
Entity Type:Organization
Organization Name:ASHE INTERNAL MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZAWODNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-846-1700
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:200 HOSPITAL AVE SUITE 6
Mailing Address - City:JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28640
Mailing Address - Country:US
Mailing Address - Phone:336-846-1700
Mailing Address - Fax:336-846-1702
Practice Address - Street 1:200 HOSPITAL AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640
Practice Address - Country:US
Practice Address - Phone:336-846-1700
Practice Address - Fax:336-846-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89898OtherBCBS NC
NC8989898Medicaid
NC2338352Medicare ID - Type Unspecified