1942288980 NPI number — GUY J WERKHOVEN DPM

Table of content: GUY J WERKHOVEN DPM (NPI 1942288980)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942288980 NPI number — GUY J WERKHOVEN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WERKHOVEN
Provider First Name:
GUY
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942288980
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 TUNNEL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28805-2576
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-298-7911
Provider Business Mailing Address Fax Number:
828-299-5868

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 TUNNEL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28805-2576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-298-7911
Provider Business Practice Location Address Fax Number:
828-299-5868
Provider Enumeration Date:
01/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213EP1101X , with the licence number:  763 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X , with the licence number: 763 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5254910001 . This is a "DMERK" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 768181047028 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 363449300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 133106 . This is a "U CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 539P8WE . This is a "BCBS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP64433 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 2700621 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 2443249 . This is a "AMERICA'S PPO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 363449300 . This is a "MEDICAL ASSISTANCE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 497P2WE . This is a "BCBS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 2700621 . This is a "MEDICA PRIMARY-EVERCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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