Provider Demographics
NPI:1407000698
Name:MASON, JERIMIAH E (MD)
Entity type:Individual
Prefix:
First Name:JERIMIAH
Middle Name:E
Last Name:MASON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1998 HENDERSONVILLE RD
Mailing Address - Street 2:SUITE #40
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2349
Mailing Address - Country:US
Mailing Address - Phone:828-585-2575
Mailing Address - Fax:828-412-4301
Practice Address - Street 1:1998 HENDERSONVILLE RD
Practice Address - Street 2:SUITE #40
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2349
Practice Address - Country:US
Practice Address - Phone:828-585-2575
Practice Address - Fax:828-412-4301
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01273208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC182XUOtherBCBS OF NC
NCP01253774OtherMEDICARE RR
NC182XUOtherBCBS OF NC