Provider Demographics
NPI:1730636028
Name:ELOHIM HOUSECALL DOCTORS P.A.
Entity Type:Organization
Organization Name:ELOHIM HOUSECALL DOCTORS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:ASENSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-372-8869
Mailing Address - Street 1:5009 BENNINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-8473
Mailing Address - Country:US
Mailing Address - Phone:917-373-8869
Mailing Address - Fax:
Practice Address - Street 1:5009 BENNINGTON WAY
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-8473
Practice Address - Country:US
Practice Address - Phone:917-373-8869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200901408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty