Provider Demographics
NPI:1518932284
Name:SACCHETTI, MARIO P (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:P
Last Name:SACCHETTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ENOLA RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4608
Mailing Address - Country:US
Mailing Address - Phone:828-433-2686
Mailing Address - Fax:828-438-6560
Practice Address - Street 1:2209 S. STERLING ST,
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-2209
Practice Address - Country:US
Practice Address - Phone:828-580-4220
Practice Address - Fax:828-580-4229
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200601047207XX0005X
NC207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904114Medicaid
PA001800770Medicaid
PA001800770Medicaid
NC5904114Medicaid
PAH16407Medicare UPIN