Basic Information
| Provider Information | |||||||||
| NPI: | 1528214442 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WAGHCHOURE | ||||||||
| FirstName: | SIMON | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2209 S STERLING ST STE 600 | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286554092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285804577 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2209 S STERLING ST STE 600 | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286554092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285804577 | ||||||||
| FaxNumber: | 8285804599 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2008 | ||||||||
| LastUpdateDate: | 08/05/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 2020-03479 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207R00000X | MD13942 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.