| North State Medical Group, P.a. | |
|
2266 Nc 16 Business North Denver NC 28037-8254 | |
| (704) 483-2200 | |
| (704) 483-2214 |
| Full Name | North State Medical Group, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 2266 Nc 16 Business North, Denver, North Carolina |
| Authorized Official Name and Position | Gerald Ahigian (PRESIDENT) |
| Authorized Official Contact | 7044832200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North State Medical Group, P.a. 2266 N Highway 16 Denver NC 28037-8254 Ph: (704) 483-2200 | North State Medical Group, P.a. 2266 Nc 16 Business North Denver NC 28037-8254 Ph: (704) 483-2200 |
| NPI Number | 1922037019 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 02/18/2015 |
| Medicare PECOS PAC ID | 0840242822 |
|---|---|
| Medicare Enrollment ID | O20050217000806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922037019 | NPI | - | NPPES |
| 890131U | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Susane Maher Habashi-ahigian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801840178 PECOS PAC ID: 8123009727 Enrollment ID: I20040528000661 |
| Provider Name | Gerald T Ahigian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932154432 PECOS PAC ID: 1658323639 Enrollment ID: I20060509000488 |
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