Provider Demographics
NPI:1942483425
Name:ASBURY, MICHAEL A (PA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:ASBURY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2630 E SEVENTH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-4318
Mailing Address - Country:US
Mailing Address - Phone:704-364-6100
Mailing Address - Fax:704-364-4245
Practice Address - Street 1:2630 E SEVENTH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-4318
Practice Address - Country:US
Practice Address - Phone:704-364-6100
Practice Address - Fax:704-364-4245
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2009-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-02024363A00000X
SCPA973363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant