Organization
ELK RIVER MEDICAL ASSOCIATES, PA
Active
Organization
ELK RIVER MEDICAL ASSOCIATES, PA
Active
Other names
Elk River Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PAUL KIMMEL MD (PRESIDENT/STAFF PHYSICIAN)
(828) 898-5177
Entity
Organization
Contact information
Practice address
150 PARK AVE, BANNER ELK, NC 28604-6604
(828) 898-5177
(828) 898-8306
Mailing address
PO BOX 1568, BANNER ELK, NC 28604-1568
(828) 898-5177
(828) 898-8306
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
38891
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0150B
NC BLUECROSS BLUESHIELD
NC
01
—
112304
TN BLUECROSS&TENNCARE
TN
05
—
4404134
—
TN
05
—
890150B
—
NC
01
—
C14617
GROUP RAILROAD MEDICARE
NC
Enumeration date
09/13/2005
Last updated
08/22/2020
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