Basic Information
| Provider Information | |||||||||
| NPI: | 1326037680 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DIGESTIVE HEALTH PARTNERS, PA | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ASHEVILLE GASTROENTEROLOGY ASSOCIATES, PA | ||||||||
| OtherOrganizationType: | 4 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 191 BILTMORE AVE | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282540881 | ||||||||
| FaxNumber: | 8283503628 | ||||||||
| Practice Location | |||||||||
| Address1: | 191 BILTMORE AVE | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282540881 | ||||||||
| FaxNumber: | 8283503026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2005 | ||||||||
| LastUpdateDate: | 12/29/2016 | ||||||||
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| AuthorizedOfficialLastName: | MAY | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8283503677 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 40524 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | CC4553 | 01 | NC | RAILROAD MEDICARE | OTHER | 01071 | 01 | NC | BCBS NORTH CAROLINA | OTHER | 8901071 | 05 | NC | MEDICAID |