Provider Demographics
NPI:1750382016
Name:VASIOS, WILLIAM (PA)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:VASIOS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-0756
Mailing Address - Country:US
Mailing Address - Phone:919-859-3373
Mailing Address - Fax:919-859-3127
Practice Address - Street 1:570 NEW WAVERLY PL
Practice Address - Street 2:SUITE 210
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-7405
Practice Address - Country:US
Practice Address - Phone:919-859-3373
Practice Address - Fax:919-859-3127
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD6395OtherMEDCOST
NCP00320509OtherRAILROAD MEDICARE
NCP00320509OtherRAILROAD MEDICARE
NCQ08896Medicare UPIN
NC2760276BMedicare PIN