| Halifax Gastroenterology Pc | |
|
1007 Gregory Dr Roanoke Rapids NC 27870-6451 | |
| (252) 535-6478 | |
| (252) 535-6483 |
| Full Name | Halifax Gastroenterology Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1007 Gregory Dr, Roanoke Rapids, North Carolina |
| Authorized Official Name and Position | Padma Devi Yerra (OFF MANAGER) |
| Authorized Official Contact | 2525356478 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Halifax Gastroenterology Pc 1007 Gregory Dr Roanoke Rapids NC 27870-6451 Ph: (252) 535-6478 | Halifax Gastroenterology Pc 1007 Gregory Dr Roanoke Rapids NC 27870-6451 Ph: (252) 535-6478 |
| NPI Number | 1306855770 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 02/04/2014 |
| Medicare PECOS PAC ID | 6103855077 |
|---|---|
| Medicare Enrollment ID | O20050810001124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306855770 | NPI | - | NPPES |
| 0167J | Other | NC | BCBS |
| 891068E | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 9700163 (North Carolina) | Primary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | AS0141 (North Carolina) | Secondary |
| Provider Name | Nagarjuna Yerra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275542649 PECOS PAC ID: 7618906587 Enrollment ID: I20050811000581 |
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