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Organization

RONCEVERTE PHYSICIAN GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization

Contact information

Practice address
202 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 647-4411
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2851
(877) 892-9813
(615) 465-3007

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
207RH0003X
Hematology & Oncology Physician
207RS0012X
Sleep Medicine (Internal Medicine) Physician
2084N0400X
Neurology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810016362
WV
Enumeration date
09/29/2009
Last updated
01/19/2010
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