Acevedo, Tania Mimi

Acevedo, Tania Mimi is an sole proprietor health care provider with primary practice located at 1818 Davie Ave , Statesville NC 28677. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Acevedo, Tania Mimi can be contacted via phone (704) 873-1036.

Contact Information

Primary practice address
1818 Davie Ave Statesville NC 28677
Phone: (704) 873-1036
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2011007275 Missouri
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 2011007275 Missouri
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2015-00788 North Carolina

Profile Details

NPI number 1386825131
LBN Legal business name Acevedo, Tania Mimi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 21st, 2007
Last updated Sep 21st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386825131 NPPES
Illinois MEDICAID 1386825131
Illinois MEDICAID 1386825131

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