Provider Demographics
NPI:1215269170
Name:SCHLEGEL, SIMON (PA-C)
Entity type:Individual
Prefix:MR
First Name:SIMON
Middle Name:
Last Name:SCHLEGEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 THOMPSON ST STE A
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2895
Mailing Address - Country:US
Mailing Address - Phone:828-697-3232
Mailing Address - Fax:
Practice Address - Street 1:PARDEE URGENT CARE FOUR SEASON
Practice Address - Street 2:212 THOMPSON STREET
Practice Address - City:SUITE A
Practice Address - State:NC
Practice Address - Zip Code:28792-2895
Practice Address - Country:US
Practice Address - Phone:828-697-3232
Practice Address - Fax:828-698-0125
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-04218363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCD463BOtherMEDICARE