| Medvantage, Pllc | |
|
294 Hwy 16n Ste C Denver NC 28037 | |
| (704) 489-2401 | |
| (704) 228-0009 |
| Full Name | Medvantage, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 294 Hwy 16n, Denver, North Carolina |
| Authorized Official Name and Position | Jamie L Redelsperger (ADMINISTRATOR) |
| Authorized Official Contact | 7044892401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medvantage, Pllc 294 Hwy 16n Ste C Denver NC 28037 Ph: (704) 489-2401 | Medvantage, Pllc 294 Hwy 16n Ste C Denver NC 28037 Ph: (704) 489-2401 |
| NPI Number | 1821218405 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 10/29/2015 |
| Medicare PECOS PAC ID | 4183665227 |
|---|---|
| Medicare Enrollment ID | O20050518000988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821218405 | NPI | - | NPPES |
| 89133E0 | Medicaid | NC | |
| DA7558 | Other | NC | RAILROAD MEDICARE |
| 133E0 | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rodney L Redelsperger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689668261 PECOS PAC ID: 8426099540 Enrollment ID: I20050606001097 |
| Provider Name | Stephen B Zimmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457424046 PECOS PAC ID: 6002919982 Enrollment ID: I20070314000127 |
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