Provider Demographics
NPI:1598851677
Name:MOLNAR, MARCIA ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:ANN
Last Name:MOLNAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607
Mailing Address - Country:US
Mailing Address - Phone:828-262-4332
Mailing Address - Fax:828-265-5514
Practice Address - Street 1:336 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-262-4332
Practice Address - Fax:828-265-5514
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002381363A00000X
NC0010-07982363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0397730004OtherNSC #
VA0110002381OtherMEDICAL LICENSE
NC1598851677Medicaid