Provider Demographics
NPI:1699784744
Name:AHEARNE, PAUL MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:MICHAEL
Last Name:AHEARNE
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 PEACHTREE RD STE 210
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3160
Practice Address - Country:US
Practice Address - Phone:828-378-5600
Practice Address - Fax:828-378-5609
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500005208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCC693C489Medicare PIN
NC891320CMedicaid
NC2010140AMedicare ID - Type Unspecified