Basic Information
| Provider Information | |||||||||
| NPI: | 1902101181 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VAPOURMD, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 124 | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281450124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044698473 | ||||||||
| FaxNumber: | 7046420529 | ||||||||
| Practice Location | |||||||||
| Address1: | 340 RIVERWOOD RD | ||||||||
| Address2: | |||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281178896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049285174 | ||||||||
| FaxNumber: | 7046626946 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2011 | ||||||||
| LastUpdateDate: | 01/19/2011 | ||||||||
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| AuthorizedOfficialLastName: | MCMULLEN | ||||||||
| AuthorizedOfficialFirstName: | JONATHAN | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | INCORPORATOR | ||||||||
| AuthorizedOfficialTelephone: | 7049285174 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 2005-01754 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.