Organization
ATLANTIC COAST NEUROSURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA H MEADOR (OFFICE MANAGER)
(540) 344-3433
Entity
Organization
Contact information
Practice address
2107 ROSALIND AVENUE, ROANOKE, VA 24014
(540) 344-3433
(540) 344-3358
Mailing address
2107 ROSALIND AVENUE, ROANOKE, VA 24014
(540) 344-3433
(540) 344-3358
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101042165
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C09822
MEDICARE GROUP #
VA
01
—
DE8364
MEDICARE RAILROAD
—
Enumeration date
08/15/2007
Last updated
08/15/2007
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