Provider Demographics
NPI:1790877306
Name:MEDICAL ASSOCIATES OF TRANSYLVANIA PA
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF TRANSYLVANIA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-862-6218
Mailing Address - Street 1:377 GALLIMORE RD
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-8874
Mailing Address - Country:US
Mailing Address - Phone:828-884-9030
Mailing Address - Fax:828-877-5054
Practice Address - Street 1:377 GALLIMORE RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-8874
Practice Address - Country:US
Practice Address - Phone:828-884-9030
Practice Address - Fax:828-877-5054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890108RMedicaid
NCCC5045OtherRAILROAD MEDICARE
NC0108ROtherBLUE CROSS BLUE SHIELD
NC0637660001OtherPALMETTO GOVERNMENT SERVI
NC=========AOtherCIGNA
NC=========AOtherCIGNA