Provider Demographics
NPI:1295053742
Name:AHERN, ANTONIA B (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIA
Middle Name:B
Last Name:AHERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4309 VINSANTO WAY
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9560
Mailing Address - Country:US
Mailing Address - Phone:571-241-3701
Mailing Address - Fax:336-370-0287
Practice Address - Street 1:912 3RD ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6967
Practice Address - Country:US
Practice Address - Phone:571-241-3701
Practice Address - Fax:336-370-0287
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD0421562084N0400X
NC2015-007922084N0400X
MDP25271207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine