| |
560 Malcolm Blvd. Suite F Rutherford College NC 28671-0848 | |
(828) 879-3400 | |
(828) 879-3403 |
Full Name | |
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Speciality | Family Medicine |
Location | 560 Malcolm Blvd., Rutherford College, North Carolina |
Authorized Official Name and Position | Gowri Devi Sathiraju (DR) |
Authorized Official Contact | 8288793400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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560 Malcolm Blvd Suite F Rutherford College NC 28671 Ph: (828) 879-3400 | 560 Malcolm Blvd. Suite F Rutherford College NC 28671-0848 Ph: (828) 879-3400 |
NPI Number | 1174671275 |
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Provider Enumeration Date | 01/08/2007 |
Last Update Date | 04/30/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174671275 | NPI | - | NPPES |
014W | Other | NC | BLUE CROSS BLUE SHIELD |
2332147 | Other | NC | MEDICARE PTAN |
89014MW | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 200001429 (North Carolina) | Primary |
207R00000X | Internal Medicine | 9901311 (North Carolina) | Secondary |
Jamie S. Young, Md, Phd, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 560 Malcolm Blvd., Suite G-2, Rutherford College, NC 28671 Phone: 828-879-4567 | |
Valdese Family Practice, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 99 Griffin Street, Rutherford College, NC 28671 Phone: 828-874-1316 Fax: 828-874-1092 |