Organization
RONCEVERTE PHYSICIAN GROUP LLC
Active
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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