Organization
FOUNTAIN SQUARE INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ALAN MALPASS M.D. (PRESIDENT)
(540) 344-5550
Entity
Organization
Contact information
Practice address
1315 2ND ST SW, STE 101, ROANOKE, VA 24016-4935
(540) 344-5550
(540) 344-5205
Mailing address
1315 2ND ST SW, STE 101, ROANOKE, VA 24016-4935
(540) 344-5550
(540) 344-5205
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/18/2006
Last updated
01/28/2010
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