Provider Demographics
NPI:1801994835
Name:ROANOKE VALLEY INTERNAL MEDICINE & RHEUMATOLOGY PC
Entity type:Organization
Organization Name:ROANOKE VALLEY INTERNAL MEDICINE & RHEUMATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-535-1082
Mailing Address - Street 1:PO BOX 1093
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-1093
Mailing Address - Country:US
Mailing Address - Phone:252-535-1082
Mailing Address - Fax:252-537-8440
Practice Address - Street 1:1724 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27570
Practice Address - Country:US
Practice Address - Phone:252-535-1082
Practice Address - Fax:252-537-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01371OtherBCBS
VA075832OtherBCBS
NC7901371Medicaid
GA660001739OtherRAILROAD MEDICARE
NC8920597Medicaid
NC1135Medicare PIN
NC01371OtherBCBS