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MR. JON DABU VERCELES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3009 NEW BERN AVE, RALEIGH, NC 27610-1214
(919) 232-5020
Mailing address
3009 NEW BERN AVE, RALEIGH, NC 27610-1214
(919) 232-5020

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03175
NC
363AM0700X
Medical Physician Assistant
0010-03175
NC
363AM0700X
Medical Physician Assistant
PA824
NV
363AS0400X
Surgical Physician Assistant
Primary
0010-03175
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100500023
NVMEDICAID
NV
05
100502898
NV
01
VWCHKL
NORIDIAN
NV
Enumeration date
02/07/2006
Last updated
09/01/2020
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