Provider Demographics
NPI:1225026289
Name:ISENHOWER, DENNIS A (PA-C)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:A
Last Name:ISENHOWER
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 1:2700 WAYNE MEMORIAL DR
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9494
Mailing Address - Country:US
Mailing Address - Phone:919-731-6060
Mailing Address - Fax:919-580-9224
Practice Address - Street 1:2700 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9494
Practice Address - Country:US
Practice Address - Phone:919-731-6060
Practice Address - Fax:919-580-9224
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104091363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC104091OtherLICENSE NUMBER
2344697OtherMEDICARE GROUP NO.
2761569AMedicare PIN
2344697OtherMEDICARE GROUP NO.
2761569BMedicare PIN