Basic Information
Provider Information
NPI: 1649835828
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNCAN
FirstName: ASHLEY
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 19305
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282199305
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 600 HOSPITAL DR
Address2:  
City: MONROE
State: NC
PostalCode: 281126000
CountryCode: US
TelephoneNumber: 7049932240
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/03/2019
LastUpdateDate: 10/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X0010-09118NCN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
208M00000X0010-09118NCY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home