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Organization

EMERGENCY BILLING GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRUCE E MAZUREK M.D. (AUTHORIZED OFFICIAL)
(276) 666-7237
Entity
Organization

Contact information

Practice address
320 HOSPITAL DR, EMERGENCY DEPT., MARTINSVILLE, VA 24112-1900
(540) 666-7237
Mailing address
PO BOX 2080, KILMARNOCK, VA 22482-2080
(804) 435-3508

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
038298
ANTHEM BCBS GRP #
05
790189Q
NC
Enumeration date
06/16/2006
Last updated
03/13/2008
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