Provider Demographics
NPI:1437157997
Name:BHIRO, DIXIE LEE (PA)
Entity Type:Individual
Prefix:MRS
First Name:DIXIE
Middle Name:LEE
Last Name:BHIRO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18901 IDA MILL RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28351-8326
Mailing Address - Country:US
Mailing Address - Phone:910-462-2707
Mailing Address - Fax:910-462-4184
Practice Address - Street 1:18901 IDA MILL RD
Practice Address - Street 2:
Practice Address - City:LAUREL HILL
Practice Address - State:NC
Practice Address - Zip Code:28351-8326
Practice Address - Country:US
Practice Address - Phone:910-462-2707
Practice Address - Fax:910-462-4184
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101560363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC101560OtherNC PA LICENSE NUMBER
MB0131425OtherDEA NUMBER