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BROOKTIETE ASSERES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3569 WILLOW GREEN DR, APEX, NC 27502-2507
(240) 338-1418
Mailing address
3569 WILLOW GREEN DR, APEX, NC 27502-2507
(240) 338-1418

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2013-01617
NC
208000000X
Pediatrics Physician
D97797
MD
208D00000X
General Practice Physician
2013-01617
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063732055
DOCTORS DIRECT
NC
05
1063732055
NC
01
13305729
PHCS-MULTIPLAN
NC
01
1513788
WELLPATH
NC
01
1806P
BCBS OF NC
NC
01
247602
MEDCOST, LLC
NC
01
3652537
UNITED HEALTHCARE
NC
01
4468100
COVENTRY NATIONAL - COVENTRY PPO
NC
01
7520999
AETNA
NC
01
9225005
CIGNA-GREATWEST
NC
01
FH1101395
FIRST CAROLINA CARE
NC
Enumeration date
06/02/2010
Last updated
07/10/2024
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