Provider Demographics
NPI:1043674088
Name:DOE, ASHLEY MAURICE
Entity type:Individual
Prefix:MR
First Name:ASHLEY
Middle Name:MAURICE
Last Name:DOE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4566 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:AYDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28513-7157
Mailing Address - Country:US
Mailing Address - Phone:252-229-7914
Mailing Address - Fax:
Practice Address - Street 1:4566 BROWN RD
Practice Address - Street 2:
Practice Address - City:AYDEN
Practice Address - State:NC
Practice Address - Zip Code:28513-7157
Practice Address - Country:US
Practice Address - Phone:252-229-7914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver