Most Relevant Information
Provider Data
| NPI Number: | 1003665290 |
| Provider Name: | MADELINE USTANIK |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/18/2024 |
| Last Updated: | 05/18/2024 |
Provider Practice Location
13235 ROBERT WALKER DR
DAVIDSON
NC
280366005
Practice Location Phone/Fax
| Phone: | 6074380748 |
| Fax: |
Provider Mailing Location
13235 ROBERT WALKER DR
DAVIDSON
NC
280366005
Provider Mailing Phone/Fax
| Phone: | 6074380748 |
| Fax: |