1578625877 NPI number — DR. MARK ANDERSON NANCE D.C.

Table of content: RONALD BENSCOTER M.D. (NPI 1538155296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578625877 NPI number — DR. MARK ANDERSON NANCE D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NANCE
Provider First Name:
MARK
Provider Middle Name:
ANDERSON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1578625877
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
169 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEAVERVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28787-8409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-645-2526
Provider Business Mailing Address Fax Number:
828-645-2521

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
169 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEAVERVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28787-8409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-645-2526
Provider Business Practice Location Address Fax Number:
828-645-2521
Provider Enumeration Date:
12/14/2006

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: 111N00000X , with the licence number:  1762 , 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: 330678 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 330678 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8908981 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 08981 . This is a "NC BLUE CROSS BLUE SHIELS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 08686 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 08686 . This is a "HEALTHCARE SAVINGS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 08686 . This is a "CNC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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