NPI 1174629414 · live from the CMS NPI Registry
Donna M Ajo, PA
Physician Assistant in Raeford, NC. National Provider Identifier 1174629414, active.
NPI record
| NPI | 1174629414 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 300 Medical Pavilion Dr Ste 150, Raeford, NC 28376 |
| Practice phone | 910-904-8025 |
| Mailing address | 504 Broad St, Apt A, Emporia, VA 23847 |
| Enumerated | September 15, 2006 |
| Last updated | May 9, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | 0110002353 (VA) |
| Physician Assistant primary | 363A00000X | 0010-00988 (NC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.