1265417356 NPI number — ANNA SCHILLING MD, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265417356 NPI number — ANNA SCHILLING MD, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANNA SCHILLING MD, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1265417356
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
420 S BROADWAY ST
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
FOREST CITY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28043-4092
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-245-1711
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 S BROADWAY ST
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
FOREST CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28043-4092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-245-1711
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SCHILLING
Authorized Official First Name:
ANNA
Authorized Official Middle Name:
DE OCAMPO
Authorized Official Title or Position:
PRACTICE OWNER
Authorized Official Telephone Number:
828-245-1711

Provider Taxonomy Codes

  • Taxonomy code: 173000000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 891293A , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com