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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