Provider Demographics
NPI:1447220389
Name:CATAWBA PEDIATRIC ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CATAWBA PEDIATRIC ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:CASHION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-624-3105
Mailing Address - Street 1:108 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-4406
Mailing Address - Country:US
Mailing Address - Phone:704-736-9244
Mailing Address - Fax:704-736-9318
Practice Address - Street 1:108 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4406
Practice Address - Country:US
Practice Address - Phone:704-736-9244
Practice Address - Fax:704-736-9318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC56950208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0135ROtherNC BCBS
NC56950OtherNC MEDICAL BOARD
NC890135RMedicaid