Organization
ROCKY MOUNT INTERNAL MEDICINE,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMATTA M SIRISENA MD (PRESIDENT)
(252) 443-7678
Entity
Organization
Contact information
Practice address
117 FOY DR, ROCKY MOUNT, NC 27804-2418
(252) 443-7678
(252) 443-7147
Mailing address
117 FOY DR, P.O.BOX 7366, ROCKY MOUNT, NC 27804-2418
(252) 443-7678
(252) 443-7147
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0149C
BLUE CROSS BLUE SHEILD
NC
05
—
890149C
—
NC
Enumeration date
06/21/2006
Last updated
10/30/2009
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