Provider Demographics
NPI:1447383773
Name:ASHEVILLE PEDIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:ASHEVILLE PEDIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCULLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-254-5326
Mailing Address - Street 1:2 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2493
Mailing Address - Country:US
Mailing Address - Phone:828-254-5326
Mailing Address - Fax:828-251-5954
Practice Address - Street 1:2 MEDICAL PARK DR
Practice Address - Street 2:SUITE 1000
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-7782
Practice Address - Country:US
Practice Address - Phone:828-254-5326
Practice Address - Fax:828-251-5954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901065Medicaid