Maqsood Ahmed Valliani, MD | |
2066 Nc 125 Hwy, Roanoke Rapids, NC 27870 | |
(252) 536-5000 | |
(252) 536-2258 |
Full Name | Maqsood Ahmed Valliani |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 2066 Nc 125 Hwy, Roanoke Rapids, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003894890 | NPI | - | NPPES |
89130YP | Medicaid | NC | |
C0598 | Other | NC | MEDCOST LLC PROVIDER # |
2001-01403 | Other | NC | NC MEDICAL LICENSE # |
2100233 | Other | NC | MAMSI PROVIDER # |
2259181 | Other | NC | UNITED HEALTH CARE # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207K00000X | Allergy & Immunology | 2001-01403 (North Carolina) | Secondary |
208000000X | Pediatrics | 2001-01403 (North Carolina) | Primary |
Entity Name | Vidant Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445 |
Mailing Address | Practice Location Address |
---|---|
Maqsood Ahmed Valliani, MD Po Box 1326, Roanoke Rapids, NC 27870-1326 Ph: (252) 536-5000 | Maqsood Ahmed Valliani, MD 2066 Nc 125 Hwy, Roanoke Rapids, NC 27870 Ph: (252) 536-5000 |
Mrs. Sheila Bhagwandass, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 52 Anna Louise Lane, Roanoke Rapids, NC 27870 Phone: 252-537-6465 Fax: 252-535-0951 | |
Paulette Keith Ingram, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 529 Becker Dr, Roanoke Rapids, NC 27870 Phone: 252-537-1400 Fax: 252-537-4936 | |
Ms. Kristen Michelle Dorsey, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2066 Nc Highway 125, Roanoke Rapids, NC 27870 Phone: 252-536-5000 Fax: 252-536-2258 | |
Lindsay Grover, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2064 Nc Highway 125, Roanoke Rapids, NC 27870 Phone: 858-472-5869 | |
Sandeep Kumar Tiwari, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 529 Becker Dr, Roanoke Rapids, NC 27870 Phone: 252-537-6465 Fax: 252-535-0951 |