| Internal Medicine Of Blacksburg Llc | |
|
3698 S Main St Blacksburg VA 24060-7015 | |
| (540) 951-6070 | |
| (540) 951-6071 |
| Full Name | Internal Medicine Of Blacksburg Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3698 S Main St, Blacksburg, Virginia |
| Authorized Official Name and Position | Kenneth Washington (VICE PRESIDENT) |
| Authorized Official Contact | 7036502907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Of Blacksburg Llc 3698 S Main St Blacksburg VA 24060-7015 Ph: (540) 951-6070 | Internal Medicine Of Blacksburg Llc 3698 S Main St Blacksburg VA 24060-7015 Ph: (540) 951-6070 |
| NPI Number | 1316985070 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 2769586247 |
|---|---|
| Medicare Enrollment ID | O20070323000208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316985070 | NPI | - | NPPES |
| 1316985070 | Medicaid | VA | |
| DF5833 | Other | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert C Solomon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902864374 PECOS PAC ID: 6002865268 Enrollment ID: I20050114000611 |
| Provider Name | Christine D Jordan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568685485 PECOS PAC ID: 6709969413 Enrollment ID: I20080218000533 |
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