| Southwest Medical Clinic | |
|
4079 Electric Rd Roanoke VA 24018-8442 | |
| (540) 989-5594 | |
| (540) 776-8020 |
| Full Name | Southwest Medical Clinic |
|---|---|
| Speciality | General Practice |
| Location | 4079 Electric Rd, Roanoke, Virginia |
| Authorized Official Name and Position | David A Cummings (PHYSICIAN-PRESIDENT) |
| Authorized Official Contact | 5409895594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Medical Clinic Po Box 4127 Roanoke VA 24015-0127 Ph: (540) 989-9394 | Southwest Medical Clinic 4079 Electric Rd Roanoke VA 24018-8442 Ph: (540) 989-5594 |
| NPI Number | 1538294640 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 07/13/2007 |
| Medicare PECOS PAC ID | 7810949955 |
|---|---|
| Medicare Enrollment ID | O20241105001455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538294640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | David A Cummings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023002615 PECOS PAC ID: 5890747935 Enrollment ID: I20050217000151 |
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