| Jefferson Internal Medicine Associates, Ltd | |
|
1111 S Jefferson St Suite B Roanoke VA 24016-4724 | |
| (540) 342-1007 | |
| (540) 345-4643 |
| Full Name | Jefferson Internal Medicine Associates, Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 S Jefferson St, Roanoke, Virginia |
| Authorized Official Name and Position | Sarah B Carroll (PRACTICE MANAGER) |
| Authorized Official Contact | 5403421007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Internal Medicine Associates, Ltd 1111 S Jefferson St Suite B Roanoke VA 24016-4724 Ph: (540) 342-1007 | Jefferson Internal Medicine Associates, Ltd 1111 S Jefferson St Suite B Roanoke VA 24016-4724 Ph: (540) 342-1007 |
| NPI Number | 1053302703 |
|---|---|
| Provider Enumeration Date | 11/02/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8426064619 |
|---|---|
| Medicare Enrollment ID | O20060227000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053302703 | NPI | - | NPPES |
| 072204 | Other | ANTHEM | |
| 3374958 | Other | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Alan Malpass |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659379675 PECOS PAC ID: 8729036488 Enrollment ID: I20060119000286 |
| Provider Name | Adel M Salama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003807496 PECOS PAC ID: 2163438219 Enrollment ID: I20100603000535 |
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