Individual
DR. JASON R AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1612 LEVEL STREAM RD, WENDELL, NC 27591-3361
(252) 347-4915
Mailing address
1612 LEVEL STREAM RD, WENDELL, NC 27591-3361
(252) 347-4915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200300115
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13306
BCBS NC
NC
05
—
8913306
—
NC
01
—
P00013099
RAILROAD MEDICARE
NC
Enumeration date
06/20/2005
Last updated
11/25/2025
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