Provider Demographics
NPI:1366673048
Name:ASENSO, PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:ASENSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 BENNINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-8473
Mailing Address - Country:US
Mailing Address - Phone:336-905-7174
Mailing Address - Fax:844-522-8775
Practice Address - Street 1:1320 N HAMILTON ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2600
Practice Address - Country:US
Practice Address - Phone:336-905-7174
Practice Address - Fax:844-522-8775
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-01408207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1533FOtherNC BLUE CROSS/BLUE SHIELD
NC5912066Medicaid
NC2074031Medicare PIN